Large discrepancy between prehospital visitation to mobile emergency care unit and discharge diagnosis.

INTRODUCTION: In Copenhagen, Denmark, patients in need of prehospital emergency assistance dial 112 and may then receive evaluation and treatment by physicians (from the Mobile Emergency Care Unit (MECU)). ST-elevation myocardial infarction (STEMI) is a severe condition leaving only a limited time frame to deliver optimal care in the form of percutaneous transluminal coronary angioplasty. In theory, all patients with chest pain could have STEMI. The aim of this study was to study which of the patients suspected of having acute cardiac disease based on the 112 calls and met by the MECU were given a cardiac diagnosis on the scene and, furthermore, to compare these on-scene diagnoses with the primary discharge diagnoses from hospital. MATERIAL AND METHODS: This was a retrospective study based on medical records from the MECU and the National Patient Registry. The study period covered six months in 2008 during which all 112-alarms to acute cardiac disease cases were met by the MECU were included. The study population comprised 1,219 patients. RESULTS: A total of 780 (66.3%) of the dispatches resulted in a cardiac diagnosis by the MECU physician. 77% of the admitted patients were diagnosed with a primary cardiac disease on discharge. These were categorized into three groups: acute coronary syndrome (314 patients, 57%), cardiac arrhythmias (58 patients, 10%), and other cardiac disorders (183 patients, 33%). Only 46% of the study population was discharged from hospital with a cardiac diagnosis CONCLUSION: Only half of the included patients were discharged from hospital with a cardiac diagnosis, which leaves room for improvement. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.