Does sex influence the allocation of life support level by dispatchers in acute chest pain?

Gellerstedt, Martin; Bång, Angela; Andréasson, Emma; Johansson, Anna; Herlitz, Johan

doi:10.1016/j.ajem.2009.05.009

« Previous Next »American Journal of Emergency Medicine
Volume 28, Issue 8 , Pages 922-927, October 2010

Does sex influence the allocation of life support level by dispatchers in acute chest pain?☆

Martin Gellerstedt, MSc, PhD
- University of Trollhättan/Uddevalla, Box 795, SE-451 26 Uddevalla, Sweden
Angela Bång, RN, PhD
- Prehospital Research Centre of Western Sweden, University College of Borås, SE- 501 90 Borås, Sweden
Emma Andréasson, MSc
- University of Trollhättan/Uddevalla, Box 795, SE-451 26 Uddevalla, Sweden
Anna Johansson, MSc
- University of Trollhättan/Uddevalla, Box 795, SE-451 26 Uddevalla, Sweden
Johan Herlitz, MD, PhD
- Prehospital Research Centre of Western Sweden, University College of Borås, SE- 501 90 Borås, Sweden
- The Prehospital Research Centre of Western Sweden, Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, SE- 413 45 Göteborg, Sweden
- Corresponding author. The Prehospital Research Centre of Western Sweden, Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. Tel.: +46 31 342 1000.

Received 5 May 2009; accepted 12 May 2009. published online 10 March 2010.

Abstract

Aim

The aim of this study was to evaluate (a) the differences between men and women in symptom profile, allocated life support level (LSL), and presence of acute myocardial infarction (AMI), life-threatening condition (LTC), or death and (b) whether a computer-based decision support system could improve the allocation of LSL.

Patients

All patients in Göteborg, Sweden, who called the dispatch center because of chest pain during 3 months (n = 503) were included in this study.

Methods

Age, sex, and symptom profile were background variables. Based on these, we studied allocation of LSL by the dispatchers and its relationship to AMI, LTC, and death. All evaluations were made from a sex perspective. Finally, we studied the potential benefit of using a statistical model for allocating LSL.

Results

The advanced life support level (ALSL) was used equally frequently for men and women. There was no difference in age or symptom profile between men and women in relation to allocation. However, the allocation of ALSL was predictive of AMI and LTC only in men. The sensitivity was far lower for women than for men. When a statistical model was used for allocation, the ALSL was predictive for both men and women. Using a separate model for men and women respectively, sensitivity increased, especially for women, and specificity was kept at the same level.

Conclusion

This exploratory study indicates that women would benefit most from the allocation of LSL using a statistical model and computer-based decision support among patients who call for an ambulance because of acute chest pain. This needs further evaluation.