title: Could ten questions asked by the dispatch center predict the outcome for patients with chest discomfort?
abstract: OBJECTIVE
  From 2009 to 2010, approximately 14,000 consecutive persons who called for the EMS due to chest discomfort were registered. From the seventh month, dispatchers ask 2285 patient ten pre-specified questions. We evaluate which of these questions was independently able to predict an acute coronary syndrome (ACS), life-threatening condition (LTC) and death.
  
  
  METHODS
  The questions asked mainly dealt with previous history and type of symptoms, each with yes/no answers. The dispatcher took a decision on priority; 1) immediately with sirens/blue light; 2) EMS on the scene within 30min; 3) normal waiting time.We examined the relationship between the answers to these questions and subsequent dispatch priority, as well as outcome, in terms of ACS, LTC and all-cause mortality.
  
  
  RESULTS
  2285 patients (mean age 67years, 49% women) took part, of which 12% had a final diagnosis of ACS and 15% had a LTC. There was a significant relationship between all the ten questions and the priority given by dispatchers. Localisation of the discomfort to the center of the chest, more intensive pain, history of angina or myocardial infarction as well as experience of cold sweat were the most important predictors when evaluating the probability of ACS and LTC. Not breathing normally and having diabetes were related to 30-day mortality.
  
  
  CONCLUSIONS
  Among individuals, who call for the EMS due to chest discomfort, the intensity and the localisation of the pain, as well as a history of ischemic heart disease, appeared to be the most strongly associated with outcome.
authors.affiliation: Varberg Hospital, Varberg, Halland County, Sweden.
authors.forename: Nina
authors.initials: N
authors.lastname: Rawshani
authors.affiliation: Department of Medicine, University of Gothenburg, Göteborg, Sweden.
authors.forename: Araz
authors.initials: A
authors.lastname: Rawshani
authors.affiliation: The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden.
authors.forename: Carita
authors.initials: C
authors.lastname: Gelang
authors.affiliation: Department of Medicine, University of Gothenburg, Göteborg, Sweden; The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
authors.affiliation: University of Borås, School of Health Science, Borås, Sweden.
authors.forename: Angela
authors.initials: A
authors.lastname: Bång
authors.affiliation: Ambulance Service, Skaraborg, Sweden.
authors.forename: Jan-Otto
authors.initials: JO
authors.lastname: Andersson
authors.affiliation: University West, School of Business, Economics and IT, Trollhättan, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Gellerstedt
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000175:diagnosis*; D000071820:Emergency Medical Dispatch / Q000379:methods* / Q000592:standards*; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards*; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome