Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services

Nertila Zylyftari; Christina Ji Young Lee; Filip Gnesin; Amalie Lykkemark Møller; Elisabeth Helen Anna Mills; Sidsel G. Møller; Britta Jensen; Kristian Bundgaard Ringgren; Kristian Kragholm; Helle Collatz Christensen; Stig Nikolaj Fasmer Blomberg; Hanno L. Tan; Fredrik Folke; Lars Køber; Gunnar Gislason; Christian Torp-Pedersen

doi:10.1016/j.ijcard.2022.12.004

Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services

Nertila Zylyftari^*, Christina Ji Young Lee, Filip Gnesin, Amalie Lykkemark Møller, Elisabeth Helen Anna Mills, Sidsel G. Møller, Britta Jensen, Kristian Bundgaard Ringgren, Kristian Kragholm, Helle Collatz Christensen, Stig Nikolaj Fasmer Blomberg, Hanno L. Tan, Fredrik Folke, Lars Køber, Gunnar Gislason, Christian Torp-Pedersen

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

1 Citation (Scopus)

21 Downloads (Pure)

Abstract

Background Early identification of warning symptoms among out-of-hospital cardiac arrest (OHCA) patients remains challenging. Thus, we examined the registered prodromal symptoms of patients who called medical helpline services within 30-days before OHCA. Methods Patients unwitnessed by emergency medical services (EMS) aged ≥18 years during their OHCA were identified from the Danish Cardiac Arrest Registry (2014–2018) and linked to phone records from the 24-h emergency helpline (1−1−2) and out-of-hours medical helpline (1813-Medical Helpline) in Copenhagen before the arrest. The registered symptoms were categorized into chest pain; breathing problems; central nervous system (CNS)-related/unconsciousness; abdominal/back/urinary; psychiatric/addiction; infection/fever; trauma/exposure; and unspecified (diverse from the beforementioned categories). Analyses were divided by the time-period of calls (0-7 days/8-30 days preceding OHCA) and call type (1–1-2/1813-Medical Helpline). Results Of all OHCA patients, 18% (974/5442) called helpline services (males 56%, median age 76 years[Q1-Q3:65–84]). Among these, 816 had 1145 calls with registered symptoms. The most common symptom categories (except for unspecified, 33%) were breathing problems (17%), trauma/exposure (17%), CNS/unconsciousness (15%), abdominal/back/urinary (12%), and chest pain (9%). Most patients (61%) called 1813-Medical Helpline, especially for abdominal/back/urinary (17%). Patients calling 1–1-2 had breathing problems (24%) and CNS/unconsciousness (23%). Nearly half of the patients called within 7 days before their OHCA, and CNS/unconsciousness (19%) was the most registered. The unspecified category remained the most common during both time periods (32%;33%) and call type (24%;39%). Conclusions Among patients who called medical helplines services up to 30-days before their OHCA, besides symptoms being highly varied (unspecified (33%)), breathing problems (17%) were the most registered symptom-specific category.

Original language	English
Journal	International Journal of Cardiology
Volume	374
Pages (from-to)	42-50
Number of pages	9
ISSN	0167-5273
DOIs	https://doi.org/10.1016/j.ijcard.2022.12.004
Publication status	Published - 2023

Bibliographical note

Publisher Copyright:
© 2022 The Author(s)

Keywords

Early warning signs
Emergency medical services
ESCAPE-NET
Medical helpline
Out-of-hospital cardiac arrest (OHCA)
Prodromal symptoms

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Cite this

Zylyftari, N., Lee, C. J. Y., Gnesin, F., Møller, A. L., Mills, E. H. A., Møller, S. G., Jensen, B., Ringgren, K. B., Kragholm, K., Christensen, H. C., Blomberg, S. N. F., Tan, H. L., Folke, F., Køber, L., Gislason, G., & Torp-Pedersen, C. (2023). Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services. International Journal of Cardiology, 374, 42-50. https://doi.org/10.1016/j.ijcard.2022.12.004

Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services. / Zylyftari, Nertila; Lee, Christina Ji Young; Gnesin, Filip ; Møller, Amalie Lykkemark; Mills, Elisabeth Helen Anna; Møller, Sidsel G.; Jensen, Britta; Ringgren, Kristian Bundgaard; Kragholm, Kristian; Christensen, Helle Collatz; Blomberg, Stig Nikolaj Fasmer; Tan, Hanno L.; Folke, Fredrik ; Køber, Lars ; Gislason, Gunnar ; Torp-Pedersen, Christian.

In: International Journal of Cardiology, Vol. 374, 2023, p. 42-50.

Research output: Contribution to journal › Journal article › Research › peer-review

Zylyftari, N, Lee, CJY, Gnesin, F , Møller, AL, Mills, EHA, Møller, SG, Jensen, B, Ringgren, KB, Kragholm, K, Christensen, HC, Blomberg, SNF, Tan, HL, Folke, F , Køber, L , Gislason, G & Torp-Pedersen, C 2023, 'Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services', International Journal of Cardiology, vol. 374, pp. 42-50. https://doi.org/10.1016/j.ijcard.2022.12.004

Zylyftari, Nertila ; Lee, Christina Ji Young ; Gnesin, Filip ; Møller, Amalie Lykkemark ; Mills, Elisabeth Helen Anna ; Møller, Sidsel G. ; Jensen, Britta ; Ringgren, Kristian Bundgaard ; Kragholm, Kristian ; Christensen, Helle Collatz ; Blomberg, Stig Nikolaj Fasmer ; Tan, Hanno L. ; Folke, Fredrik ; Køber, Lars ; Gislason, Gunnar ; Torp-Pedersen, Christian. / Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services. In: International Journal of Cardiology. 2023 ; Vol. 374. pp. 42-50.

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title = "Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services",

abstract = "Background Early identification of warning symptoms among out-of-hospital cardiac arrest (OHCA) patients remains challenging. Thus, we examined the registered prodromal symptoms of patients who called medical helpline services within 30-days before OHCA. Methods Patients unwitnessed by emergency medical services (EMS) aged ≥18 years during their OHCA were identified from the Danish Cardiac Arrest Registry (2014–2018) and linked to phone records from the 24-h emergency helpline (1−1−2) and out-of-hours medical helpline (1813-Medical Helpline) in Copenhagen before the arrest. The registered symptoms were categorized into chest pain; breathing problems; central nervous system (CNS)-related/unconsciousness; abdominal/back/urinary; psychiatric/addiction; infection/fever; trauma/exposure; and unspecified (diverse from the beforementioned categories). Analyses were divided by the time-period of calls (0-7 days/8-30 days preceding OHCA) and call type (1–1-2/1813-Medical Helpline). Results Of all OHCA patients, 18% (974/5442) called helpline services (males 56%, median age 76 years[Q1-Q3:65–84]). Among these, 816 had 1145 calls with registered symptoms. The most common symptom categories (except for unspecified, 33%) were breathing problems (17%), trauma/exposure (17%), CNS/unconsciousness (15%), abdominal/back/urinary (12%), and chest pain (9%). Most patients (61%) called 1813-Medical Helpline, especially for abdominal/back/urinary (17%). Patients calling 1–1-2 had breathing problems (24%) and CNS/unconsciousness (23%). Nearly half of the patients called within 7 days before their OHCA, and CNS/unconsciousness (19%) was the most registered. The unspecified category remained the most common during both time periods (32%;33%) and call type (24%;39%). Conclusions Among patients who called medical helplines services up to 30-days before their OHCA, besides symptoms being highly varied (unspecified (33%)), breathing problems (17%) were the most registered symptom-specific category.",

keywords = "Early warning signs, Emergency medical services, ESCAPE-NET, Medical helpline, Out-of-hospital cardiac arrest (OHCA), Prodromal symptoms",

author = "Nertila Zylyftari and Lee, {Christina Ji Young} and Filip Gnesin and M{\o}ller, {Amalie Lykkemark} and Mills, {Elisabeth Helen Anna} and M{\o}ller, {Sidsel G.} and Britta Jensen and Ringgren, {Kristian Bundgaard} and Kristian Kragholm and Christensen, {Helle Collatz} and Blomberg, {Stig Nikolaj Fasmer} and Tan, {Hanno L.} and Fredrik Folke and Lars K{\o}ber and Gunnar Gislason and Christian Torp-Pedersen",

note = "Publisher Copyright: {\textcopyright} 2022 The Author(s)",

year = "2023",

doi = "10.1016/j.ijcard.2022.12.004",

language = "English",

volume = "374",

pages = "42--50",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services

AU - Zylyftari, Nertila

AU - Lee, Christina Ji Young

AU - Gnesin, Filip

AU - Møller, Amalie Lykkemark

AU - Mills, Elisabeth Helen Anna

AU - Møller, Sidsel G.

AU - Jensen, Britta

AU - Ringgren, Kristian Bundgaard

AU - Kragholm, Kristian

AU - Christensen, Helle Collatz

AU - Blomberg, Stig Nikolaj Fasmer

AU - Tan, Hanno L.

AU - Folke, Fredrik

AU - Køber, Lars

AU - Gislason, Gunnar

AU - Torp-Pedersen, Christian

PY - 2023

Y1 - 2023

N2 - Background Early identification of warning symptoms among out-of-hospital cardiac arrest (OHCA) patients remains challenging. Thus, we examined the registered prodromal symptoms of patients who called medical helpline services within 30-days before OHCA. Methods Patients unwitnessed by emergency medical services (EMS) aged ≥18 years during their OHCA were identified from the Danish Cardiac Arrest Registry (2014–2018) and linked to phone records from the 24-h emergency helpline (1−1−2) and out-of-hours medical helpline (1813-Medical Helpline) in Copenhagen before the arrest. The registered symptoms were categorized into chest pain; breathing problems; central nervous system (CNS)-related/unconsciousness; abdominal/back/urinary; psychiatric/addiction; infection/fever; trauma/exposure; and unspecified (diverse from the beforementioned categories). Analyses were divided by the time-period of calls (0-7 days/8-30 days preceding OHCA) and call type (1–1-2/1813-Medical Helpline). Results Of all OHCA patients, 18% (974/5442) called helpline services (males 56%, median age 76 years[Q1-Q3:65–84]). Among these, 816 had 1145 calls with registered symptoms. The most common symptom categories (except for unspecified, 33%) were breathing problems (17%), trauma/exposure (17%), CNS/unconsciousness (15%), abdominal/back/urinary (12%), and chest pain (9%). Most patients (61%) called 1813-Medical Helpline, especially for abdominal/back/urinary (17%). Patients calling 1–1-2 had breathing problems (24%) and CNS/unconsciousness (23%). Nearly half of the patients called within 7 days before their OHCA, and CNS/unconsciousness (19%) was the most registered. The unspecified category remained the most common during both time periods (32%;33%) and call type (24%;39%). Conclusions Among patients who called medical helplines services up to 30-days before their OHCA, besides symptoms being highly varied (unspecified (33%)), breathing problems (17%) were the most registered symptom-specific category.

AB - Background Early identification of warning symptoms among out-of-hospital cardiac arrest (OHCA) patients remains challenging. Thus, we examined the registered prodromal symptoms of patients who called medical helpline services within 30-days before OHCA. Methods Patients unwitnessed by emergency medical services (EMS) aged ≥18 years during their OHCA were identified from the Danish Cardiac Arrest Registry (2014–2018) and linked to phone records from the 24-h emergency helpline (1−1−2) and out-of-hours medical helpline (1813-Medical Helpline) in Copenhagen before the arrest. The registered symptoms were categorized into chest pain; breathing problems; central nervous system (CNS)-related/unconsciousness; abdominal/back/urinary; psychiatric/addiction; infection/fever; trauma/exposure; and unspecified (diverse from the beforementioned categories). Analyses were divided by the time-period of calls (0-7 days/8-30 days preceding OHCA) and call type (1–1-2/1813-Medical Helpline). Results Of all OHCA patients, 18% (974/5442) called helpline services (males 56%, median age 76 years[Q1-Q3:65–84]). Among these, 816 had 1145 calls with registered symptoms. The most common symptom categories (except for unspecified, 33%) were breathing problems (17%), trauma/exposure (17%), CNS/unconsciousness (15%), abdominal/back/urinary (12%), and chest pain (9%). Most patients (61%) called 1813-Medical Helpline, especially for abdominal/back/urinary (17%). Patients calling 1–1-2 had breathing problems (24%) and CNS/unconsciousness (23%). Nearly half of the patients called within 7 days before their OHCA, and CNS/unconsciousness (19%) was the most registered. The unspecified category remained the most common during both time periods (32%;33%) and call type (24%;39%). Conclusions Among patients who called medical helplines services up to 30-days before their OHCA, besides symptoms being highly varied (unspecified (33%)), breathing problems (17%) were the most registered symptom-specific category.

KW - Early warning signs

KW - Emergency medical services

KW - ESCAPE-NET

KW - Medical helpline

KW - Out-of-hospital cardiac arrest (OHCA)

KW - Prodromal symptoms

U2 - 10.1016/j.ijcard.2022.12.004

DO - 10.1016/j.ijcard.2022.12.004

M3 - Journal article

C2 - 36496039

AN - SCOPUS:85144923782

VL - 374

SP - 42

EP - 50

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -