{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T06:13:41Z","timestamp":1681712021282},"reference-count":27,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2015,2,10]],"date-time":"2015-02-10T00:00:00Z","timestamp":1423526400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1049023X15000060_abs1\" sec-type=\"general\"><jats:title>Purpose<\/jats:title><jats:p>Aortic dissection is difficult to detect in the early phase due to a variety of symptoms. This report describes the prehospital setting of aortic dissection in terms of symptoms, treatment, and suspicion by the Emergency Medical Service (EMS) staff.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X15000060_abs2\" sec-type=\"general\"><jats:title>Basic Procedures<\/jats:title><jats:p>All patients in the Municipality of Gothenburg, Sweden, who, in 2010 and 2011, had a hospital discharge diagnosis of aortic dissection (international classification of disease (ICD) I 71,0) were included. The exclusion criteria were: age &lt; 18 years of age and having a planned operation. This was a retrospective, descriptive study based on patient records. In the statistical analyses, Fisher's exact test and the Mann-Whitney U test were used for analyses of dichotomous and continuous\/ordered variables.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X15000060_abs3\" sec-type=\"general\"><jats:title>Main findings<\/jats:title><jats:p>Of 92 patients, 78% were transported to the hospital by the EMS. The most common symptom was pain (94%). Pain was intensive or very intensive in 89% of patients, with no significant difference in relation to the use of the EMS. Only 47% of those using the EMS were given pain relief with narcotic analgesics. Only 12% were free from pain on admission to the hospital. A suspicion of aortic dissection was reported by the EMS staff in only 17% of cases. The most common preliminary diagnosis at the dispatch center (31%) and by EMS clinicians (52%) was chest pain or angina pectoris. In all, 79% of patients were discharged alive from the hospital (75% of those that used the EMS and 95% of those that did not).<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X15000060_abs4\" sec-type=\"general\"><jats:title>Conclusion<\/jats:title><jats:p>Among patients who were hospitalized due to aortic dissection in Gothenburg, 78% used the EMS. Despite severe pain in the majority of patients, fewer than half received narcotic analgesics, and only 12% were free from pain on admission to the hospital. In fewer than one-in-five patients was a suspicion of aortic dissection reported by the EMS staff.<\/jats:p><jats:p><jats:mixed-citation id=\"S1049023X15000060_ref\" publication-type=\"journal\"><jats:name name-style=\"western\"><jats:surname>Axelsson<\/jats:surname><jats:given-names>C<\/jats:given-names><\/jats:name>, <jats:name name-style=\"western\"><jats:surname>Karlsson<\/jats:surname><jats:given-names>T<\/jats:given-names><\/jats:name>, <jats:name name-style=\"western\"><jats:surname>Pande<\/jats:surname><jats:given-names>K<\/jats:given-names><\/jats:name>, <jats:name name-style=\"western\"><jats:surname>Wigertz<\/jats:surname><jats:given-names>K<\/jats:given-names><\/jats:name>, <jats:name name-style=\"western\"><jats:surname>\u00d6rtenwall<\/jats:surname><jats:given-names>P<\/jats:given-names><\/jats:name>, <jats:name name-style=\"western\"><jats:surname>Nordanstig<\/jats:surname><jats:given-names>J<\/jats:given-names><\/jats:name>, <jats:name name-style=\"western\"><jats:surname>Herlitz<\/jats:surname><jats:given-names>J<\/jats:given-names><\/jats:name>. <jats:article-title>A description of the prehospital phase of aortic dissection in terms of early suspicion and treatment<\/jats:article-title>. <jats:source>Prehosp Disaster Med<\/jats:source>. <jats:year>2015<\/jats:year>;<jats:volume>30<\/jats:volume>(<jats:issue>2<\/jats:issue>):<jats:fpage>1<\/jats:fpage>-<jats:lpage>8<\/jats:lpage><\/jats:mixed-citation>.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1049023x15000060","type":"journal-article","created":{"date-parts":[[2015,2,10]],"date-time":"2015-02-10T09:03:39Z","timestamp":1423559019000},"page":"155-162","source":"Crossref","is-referenced-by-count":4,"title":["A Description of the Prehospital Phase of Aortic Dissection in Terms of Early Suspicion and 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