Related Experiment Video
Updated: May 23, 2026
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Large discrepancy between prehospital visitation to mobile emergency care unit and discharge diagnosis
Christine Puck Holler1, Sine Wichmann, Søren Loumann Nielsen
1Department of Anaesthesiology, Hvidovre Hospital, Denmark. christineholler@gmail.com
Insights
Emergency physicians diagnosed cardiac conditions in 66.3% of patients. However, only 46% of patients received a cardiac diagnosis upon hospital discharge, indicating a need for improved diagnostic accuracy in emergency cardiac care.
Area of Science:
- Emergency Medicine
- Cardiology
- Public Health
Background:
- Prehospital emergency care in Copenhagen involves physician-led Mobile Emergency Care Units (MECU) responding to 112 calls.
- ST-elevation myocardial infarction (STEMI) requires timely intervention, making accurate on-scene diagnosis crucial.
- The study investigates the diagnostic accuracy of MECU physicians for suspected acute cardiac conditions.
Purpose of the Study:
- To determine the proportion of patients with suspected acute cardiac disease who received a cardiac diagnosis from MECU physicians.
- To compare MECU on-scene cardiac diagnoses with primary hospital discharge diagnoses.
Main Methods:
- Retrospective analysis of medical records from MECU and the National Patient Registry.
- Inclusion of all 112-alarms for acute cardiac disease cases attended by MECU over a six-month period in 2008.
- Study population comprised 1,219 patients.
Main Results:
- MECU physicians provided a cardiac diagnosis in 66.3% of cases (780 patients).
- Of admitted patients, 77% received a primary cardiac diagnosis upon discharge.
- Only 46% of the total study population was discharged with a cardiac diagnosis.
Conclusions:
- A significant discrepancy exists between on-scene cardiac diagnoses and hospital discharge diagnoses.
- The findings suggest potential for improvement in the diagnostic process for acute cardiac conditions in the prehospital setting.
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.
Related Concept Videos
01:31Discharge Summary Forms
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
01:10Documentation of Nursing Diagnosis
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:21Planning Nursing Care I
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care