Validación de un cuestionario telefónico para el diagnóstico diferencial del síntoma de disnea en emergencias sanitarias

Abstract

Introduction In emergency coordination centers, the availability of a scientifically validated instrument would improve resource allocation. This is especially important in patients reporting dyspnea, in whom rapid action can improve survival and subsequent quality oflife. The objective of this study was to validate a telephone protocol for the identification of emergency disease among patients requesting healthcare for dyspnea using the 061 emergency service of Andalusia (Spain). Material and method Design: Cross-sectional study. Study setting: Region of Andalusia. Study subjects: A randomized sample of 1700 patients was selected from a wider sample of 21000 patients with dyspnea calling 061 for healthcare. Instruments: A telephone questionnaire was designed by a panel of experts. This questionnaire was applied to all calls reporting dyspnea on days 1, 5, 10, 15, 20 and 25 of each month during a 1-year period. Emergency cases were subsequently identified by a search of the hospital records, and the diagnosis of the emergency team and telephone followup of patients were recorded. Logistic regression was used to construct the model, and its calibration and discrimination were then deter-mined. Results A final protocol was obtained from the logistic regression model and included the following variables: sudden onset of dyspnea and a history of asthma or exacerbation of chronic bronchitis. The calibration test showed a χ 2 with p < 0.05. The area under the ROC curve was 0.8500 (p < 0.05). Conclusions The proposed protocol identifies emergency from non-emergency patients from among those calling 061 for dyspnea.