Factors influencing utilization of pre- emergency medical services in patients with acute chest pain

Abstract

Objective To describe the general characteristics of patients with acute chest pain in order to analyze factors associated with patients’ utilization of emergency medical services (EMS). Methods A total of 747 eligible patients with acute chest pain admitted to emergency department of Qilu Hospital were consecutively enrolled from October 2014 to April 2015. Clinical data including demographic features, mode of arrival, past medical history, risk factors, symptoms and signs were collected prospectively by using standardized case report form. Univariate and multivariate analyses were carried out to investigate the association between the decision to use EMS and related factors including demographic features, past medical history, risk factors, symptoms and signs. Results Of the total 747 eligible patients, 414(55.4%) were male , and the mean age was (57.2 ± 15.8)year; 333(44.6%) were female, and the mean age was (61.7±14.9)year. Of them, 171 (22.9%)patients used EMS, and 143 chest pain patients with more than 75 years old were more inclined to use EMS (P<0.01), whereas 152 patients in 65-75 years age group accounted for the lowest proportion of using EMS. Men were more inclined to use EMS than women(P<0.05), and 483 patients with typical chest pain used more EMS than patients with atypical chest pain (P<0.05); Of them, 356 patients with a history of hypertension and 54 patients with a history of cerebral infarction were more inclined to use EMS (P<0.05 and P<0.01, respectively). Multivariate logistic regression analysis showed that male, older than 75 years, history of cerebral infarction were independent factors associated with EMS use (P<0.05). Conclusions This study indicated that only less than one-third of emergency department visits with acute chest pain decide to use EMS when symptoms occurred. Factors including male, older than 75 years, and a history of cerebral infarction were associated with more use of EMS. In order to promote patient asking for EMS timely, more work should be done. Key words: Acute chest pain; Emergency medical services; Influencing factors