Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services

Nertila Zylyftari*, Christina Ji-Young Lee, Filip Gnesin, Amalie Lykkemark Møller, Elisabeth Helen Anna Mills, Sidsel G. Møller, Britta Jensen, Kristian Bundgaard Ringgren, Kristian Kragholm, Helle Collatz Christensen, Stig Nikolaj Fasmer Blomberg, Hanno L. Tan, Fredrik Folke, Lars Køber, Gunnar Gislason, Christian Torp-Pedersen

*Corresponding author for this work

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Background Early identification of warning symptoms among out-of-hospital cardiac arrest (OHCA) patients remains challenging. Thus, we examined the registered prodromal symptoms of patients who called medical helpline services within 30-days before OHCA. Methods Patients unwitnessed by emergency medical services (EMS) aged ≥18 years during their OHCA were identified from the Danish Cardiac Arrest Registry (2014-2018) and linked to phone records from the 24-h emergency helpline (1-1-2) and out-of-hours medical helpline (1813-Medical Helpline) in Copenhagen before the arrest. The registered symptoms were categorized into chest pain; breathing problems; central nervous system (CNS)-related/unconsciousness; abdominal/back/urinary; psychiatric/addiction; infection/fever; trauma/exposure; and unspecified (diverse from the beforementioned categories). Analyses were divided by the time-period of calls (0-7 days/8-30 days preceding OHCA) and call type (1-1-2/1813-Medical Helpline). Results Of all OHCA patients, 18% (974/5442) called helpline services (males 56%, median age 76 years[Q1-Q3:65-84]). Among these, 816 had 1145 calls with registered symptoms. The most common symptom categories (except for unspecified, 33%) were breathing problems (17%), trauma/exposure (17%), CNS/unconsciousness (15%), abdominal/back/urinary (12%), and chest pain (9%). Most patients (61%) called 1813-Medical Helpline, especially for abdominal/back/urinary (17%). Patients calling 1-1-2 had breathing problems (24%) and CNS/unconsciousness (23%). Nearly half of the patients called within 7 days before their OHCA, and CNS/unconsciousness (19%) was the most registered. The unspecified category remained the most common during both time periods (32%;33%) and call type (24%;39%). Conclusions Among patients who called medical helplines services up to 30-days before their OHCA, besides symptoms being highly varied (unspecified (33%)), breathing problems (17%) were the most registered symptom-specific category.

Original languageEnglish
JournalInternational Journal of Cardiology
Pages (from-to)42-50
Number of pages9
Publication statusPublished - 1 Mar 2023

Bibliographical note

Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.


  • Early warning signs
  • Emergency medical services
  • Medical helpline
  • Out-of-hospital cardiac arrest (OHCA)
  • Prodromal symptoms


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