Emergency Call versus General Practitioner Requested Ambulances – Patient Mortality, Disease Severity and Pattern

Figures & data

Figure 1 Study inclusion flowchart of all ambulance patients between July 1st 2016 to December 31st 2020 in the North Denmark Region (N = 255487).

Table 1 Demographics, Characteristics, and Outcome Rates for All Ambulance Patients (N = 255487)

	All	GP-Requested Patients	Emergency Call Patients	p-value
Missing Civil Registration Number, N (%)	17,721	4421 (24.9)	13,300 (75.1)
N (%)	255,487 (100.0)	119,361 (46.7)	136,126 (53.3)
N unique	133,587	88,242	78,582
Age, median [IQR]	68 [48–80]	73 [58–83]	61 [37–76]	<0.0001
Sex=Female, n (%)	122,192 (47.8)	59,396 (49.8)	62,796 (46.1)	<0.0001
Charlson Comorbidity Index*				<0.0001
None/missing (0)	160,522 (62.8)	65,143 (56.0)	95,379 (75.5)
Mild (1–2)	62,222 (24.4)	37,350 (32.1)	24,872 (19.7)
Moderate/severe (≥3)	19,951 (7.8)	13,806 (11.9)	6145 (4.9)
1-day mortality, n, %, (95% CI)	5550, 2.2 (2.2–2.3)	1425, 1.2 (1.2–1.3)	4125, 3.1 (3.0–3.2)	<0.0001
7-day mortality, n, %, (95% CI)	10,379, 4.3 (4.3–4.4)	4833, 4.5 (4.4–4.6)	5546, 4.2 (4.1–4.3)	0.0006
30-day mortality, n, %, (95% CI)	15,723, 6.9 (6.8–7.0)	8996, 9.0 (8.8–9.2)	6727, 5.2 (5.1–5.4)	<0.0001
No hospital contact, n, %	40,273 (15.8)	22,249 (18.6)	18,024 (13.2)	<0.0001
Hospital contact, n, %**	215,214 (84.2)	97,112 (81.4)	118,102 (86.8)	<0.0001
First department: Emergency department, n, %***	177,414 (82.4)	70,296 (72.4)	107,118 (90.7)	<0.0001
ICU Admission, n, %	5427 (2.5)	2076 (2.1)	3351 (2.8)	<0.0001
Hospital length of stay, days, median, [IQR]	1.0 [0.2–4.0]	2.2 [0.6–5.8]	0.5 [0.1–2.1]	<0.0001

Notes: *Patients aged 16 or younger not included when reporting CCI (12792 patients excluded). **Details regarding departments, ICU admission and length of stay concerns patients brought to hospital only (N = 215214). ***Patients brought to the emergency department as the first department.

Figure 2 Age distribution of all ambulance patients stratified by emergency call status (N = 255,487).

Figure 3 Distribution of mNEWS2 scores for all ambulance patients aged >16 years stratified by emergency call status (N = 220344).

Figure 4 Plot of co-variate hazard ratios for the Cox Proportional Hazard model of mortality (N = 220,344).

Figure 5 Number of diagnoses, mortality and number of deaths stratified by emergency call status and first primary diagnosis, according to the International Classification of Diseases 10th Edition (ICD-10) for ambulance patients brought to hospital (N = 215214).

Abbreviation: M30: 30-day mortality.

Data Sharing Statement

Data cannot be shared publicly as it contains sensitive patient information and restrictions apply. However, for researchers who have obtained approval for the handover of medical records (https://rn.dk/da/Til-fagfolk/Sundhed/Forskning/Videregivelse-af-patientjournaloplysninger), the dataset can be constructed by requesting data from the North Denmark EMS, and the Danish health data Authority at https://sundhedsdatastyrelsen.dk/da/english/health_data_and_registers/research_services/before_applying.