Management of chest pain in the French emergency healthcare system: the prospective observational EPIDOULTHO study.

Details

Serval ID
serval:BIB_AAE27981AE84
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Management of chest pain in the French emergency healthcare system: the prospective observational EPIDOULTHO study.
Journal
European journal of emergency medicine
Author(s)
Charpentier S., Beaune S., Joly L.M., Khoury A., Duchateau F.X., Briot R., Renaud B., Ageron F.X.
Working group(s)
IRU Network
ISSN
1473-5695 (Electronic)
ISSN-L
0969-9546
Publication state
Published
Issued date
12/2018
Peer-reviewed
Oui
Volume
25
Number
6
Pages
404-410
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Observational Study
Publication Status: ppublish
Abstract
The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS).
All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013. Data on diagnostic and therapeutic management and disposition were collected. An in-hospital follow-up was performed.
In total, 1339 patients were included: 537 from SAMU, 187 attended by a MICU and 615 in EDs. Diagnosing ACS was the main diagnostic strategy of the French emergency care system, diagnosed in 16% of SAMU patients, 25% of MICU patients and 10% of ED patients. Among patients calling the SAMU, 76 (14%) received only medical advice, 15 (8%) patients remained at home after being seen by a MICU and 454 (74%) were discharged from an ED.
Management of chest pain at the three levels of the French medical emergency system is mainly oriented towards ruling out ACS. The strategy of diagnostic management is based on minimizing missed diagnoses of ACS.
Keywords
Acute Coronary Syndrome/diagnosis, Acute Coronary Syndrome/mortality, Acute Coronary Syndrome/therapy, Age Factors, Aged, Chest Pain/diagnosis, Chest Pain/epidemiology, Chest Pain/therapy, Chi-Square Distribution, Disease Management, Emergency Medical Services/organization & administration, Emergency Service, Hospital/organization & administration, Female, France, Humans, Intensive Care Units/organization & administration, Male, Middle Aged, Outcome Assessment, Health Care, Prospective Studies, Risk Assessment, Sex Factors, Statistics, Nonparametric, Survival Rate
Pubmed
Web of science
Create date
09/03/2021 11:39
Last modification date
02/03/2022 7:35
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