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We used data from the Danish Prehospital Database 2016\u20132017 and the Danish Emergency Surgery Registry 2004\u20132018 combined with data from other Danish databases. Patients were categorized according to severity of mental health history.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We identified 4.767 patients undergoing emergency surgery for perforated ulcer. Among patients calling the EMS with no history of mental illness, 51% were identified with abdominal pain when calling the EMS compared to 31% and 25% among patients with a history of moderate and major mental illness, respectively. Median time from hospital arrival to surgery was 6.0\u00a0h (IQR: 3.6;10.7). Adjusting for age, sex and comorbidity, patients with a history of major mental illness underwent surgery 46\u00a0min (95% CI: 4;88) later compared to patients with no history of mental illness. Median number of days-alive-and-out-of-hospital at 90-day follow-up was 67\u00a0days (IQR: 0;83). Adjusting for age, sex and comorbidity, patients with a history of major mental illness had 9\u00a0days (95% CI: 4;14) less alive and out-of-hospital at 90-day follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>One-third of the population had a history of mental illness or vulnerability. Patients with a history of major mental illness were less likely to be identified with abdominal pain if calling the EMS prior to arrival. They had longer delays from hospital arrival to surgery and higher mortality.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-023-02427-1","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T11:02:11Z","timestamp":1707908531000},"page":"975-985","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Disparities in prehospital and emergency surgical care among patients with perforated ulcers and a history of mental illness: a nationwide cohort study"],"prefix":"10.1007","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7155-4105","authenticated-orcid":false,"given":"Julie","family":"Mackenhauer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika Frischknecht","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Mainz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Brink","family":"Valentin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolai Bang","family":"Foss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Olsen","family":"Svenningsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren Paaske","family":"Johnsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"2427_CR1","doi-asserted-by":"publisher","first-page":"379","DOI":"10.5694\/mja2.51009","volume":"214","author":"KE McBride","year":"2021","unstructured":"McBride KE, Solomon MJ, Bannon PG, Glozier N, Steffens D. 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