{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:33:53Z","timestamp":1792100033561,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T00:00:00Z","timestamp":1646006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004102","name":"Laerdal Foundation for Acute Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008376","name":"Helsingin ja Uudenmaan Sairaanhoitopiiri","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008376","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ambulance patients are usually transported to the hospital in the emergency medical service (EMS) system. The aim of this study was to describe the non\u2010conveyance practice in the Helsinki EMS system and to report mortality following non\u2010conveyance decisions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All prehospital patients \u226516\u00a0years attended by the EMS but not transported to a hospital during 2013\u20132017 were included in the study. EMS mission\u2010 and patient\u2010related factors were collected and examined in relation to patient death within 30\u00a0days of the EMS non\u2010conveyance decision.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The EMS performed 324,207\u00a0missions with a patient during the study period. The patient was not transported in 95,909 (29.6%) missions; 72,233\u00a0missions met the study criteria. The patient mean age (standard deviation) was 59.5 (22.5) years; 55.5% of patients were female. The most common dispatch codes were malaise (15.0%), suspected decline in vital signs (14.0%), and falling over (12.9%). A total of 960 (1.3%) patients died within 30\u00a0days after the non\u2010conveyance decision. Multivariate logistic regression analysis revealed that mortality was associated with the patient's inability to walk (odds ratio 3.19, 95% confidence interval 2.67\u20133.80), ambulance dispatch due to shortness of breath (2.73, 2.27\u20133.27), decreased level of consciousness (2.72, 1.75\u20134.10), decreased blood oxygen saturation (2.64, 2.27\u20133.06), and abnormal systolic blood pressure (2.48, 1.79\u20133.37).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>One\u2010third of EMS missions did not result in patient transport to the hospital. Thirty\u2010day mortality was 1.3%. Abnormalities in multiple respiratory\u2010related vital signs were associated with an increased likelihood of death within 30\u00a0days.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14049","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T08:06:51Z","timestamp":1644998811000},"page":"625-633","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Ambulance crew\u2010initiated non\u2010conveyance in the Helsinki EMS system\u2014A retrospective cohort study"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9824-8941","authenticated-orcid":false,"given":"Kari","family":"Heinonen","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine &amp; Services Helsinki University Hospital and University of Helsinki  Helsinki Finland"},{"name":"Department of Anesthesiology &amp; Intensive Care Medicine Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3748-1202","authenticated-orcid":false,"given":"Tuukka","family":"Puolakka","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine &amp; Services Helsinki University Hospital and University of Helsinki  Helsinki Finland"},{"name":"Department of Anesthesiology &amp; Intensive Care Medicine Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0565-0593","authenticated-orcid":false,"given":"Heli","family":"Salmi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology &amp; Intensive Care Medicine Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Boyd","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine &amp; Services Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Laiho","sequence":"additional","affiliation":[{"name":"Parliament of Finland  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Porthan","sequence":"additional","affiliation":[{"name":"Helsinki City Rescue Department  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0104-4553","authenticated-orcid":false,"given":"Heini","family":"Harve\u2010Ryts\u00e4l\u00e4","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine &amp; Services Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3057-6524","authenticated-orcid":false,"given":"Markku","family":"Kuisma","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine &amp; Services Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-380"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1071\/AH09866"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-007726"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/31270300220X"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/1735\u20101995.200277"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00508\u2010019\u201001596\u20107"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/10903129808958834"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X0004156X"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2000.tb02041.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2007.048850"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-018-0540-z"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_9_14_1","unstructured":"Official Statistics of Finland (OSF) [Internet]. 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