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Multicenter Study
. 2015 Jul-Aug;48(4):520-6.
doi: 10.1016/j.jelectrocard.2015.01.014. Epub 2015 Feb 2.

Normal prehospital electrocardiography is linked to long-term survival in patients presenting to the emergency department with symptoms of acute coronary syndrome

Jessica K Zègre-Hemsey  1 , Claire E Sommargren  2 , Josephine K Asafu-Adjei  3 , Barbara J Drew  2
Affiliations
Multicenter Study

Normal prehospital electrocardiography is linked to long-term survival in patients presenting to the emergency department with symptoms of acute coronary syndrome

Jessica K Zègre-Hemsey et al. J Electrocardiol. 2015 Jul-Aug.

Abstract

Aims/methods: We studied 735 patients who activated "911" for chest pain and/or anginal equivalent symptoms and received 12-lead ECG monitoring with specialized ischemia monitoring software in the ambulance. Prehospital electrocardiograms (PH ECG) were analyzed to determine the proportion of patients who present with completely normal PH ECG findings (absence of ischemia/infarction, arrhythmia, or any other abnormality) and to compare outcomes among patients with and without any PH ECG abnormality.

Results: Of 735 patients (mean age 70.5, 52.4% male), 68 (9.3%) patients had completely normal PH ECG findings. They experienced significantly less adverse hospital outcomes (12% vs 37%), length of stay (1.19 vs 3.86 days), and long-term mortality (9% vs 28%) than those with any PH ECG abnormality (p<.05).

Conclusion: Normal PH ECG findings are associated with better short and long-term outcomes in ambulance patients with ischemic symptoms. These findings may enhance early triage and risk stratification in emergency cardiac care.

Keywords: Acute coronary syndrome; Emergency medical services; Prehospital electrocardiography; ST-segment monitoring.

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Figures

Figure 1
Figure 1
Patient enrollment summary (including total number of patients screened for the ST SMART trial, the number of patients excluded due to PH ECG technical problems, the number of patients who consented, and those excluded due to duplicate enrollments).
See this image and copyright information in PMC

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