Fig 1.
Study population considering the inclusion and exclusion criteria.
PEMT physician-staffed emergency medical team.
Fig 2.
Frequency of discharge diagnoses and diagnostic accuracy of the PEMT.
PEMT: physician-staffed emergency medical team; COPD: chronic obstructive pulmonary disease; ACS: acute coronary syndrome; NSTE-ACS: non-ST segment elevation ACS; STEMI: ST-elevation myocardial infarction; total of number of discharge diagnoses made: 793.
Table 1.
Characterization of patients, PEMT encounters, and hospital follow-up.
Fig 3.
Which out-of-hospital diagnoses did the PEMTs suspect in cases of misdiagnosis?
Fig 3 shows the incorrect PEMT out-of-hospital diagnoses for the three most frequent discharge diagnoses; PEMT: physician-staffed emergency medical team; COPD: chronic obstructive pulmonary disease.
Fig 4.
Associations of initial examination findings and discharge diagnoses.
Binary logistic regression; only significant results are displayed, * mean of the odds ratios (when identical auscultation findings in the out-of-hospital setting and in the emergency department yielded significant results). The following variables were reviewed for associations with discharge diagnoses: out-of-hospital findings: hypotension (systolic blood pressure < 100 mmHg), tachycardia (heart rate > 100/min), low oxygen saturation (peripheral oxygen saturation < 90%), tachypnea (respiratory rate ≥ 22/min), high temperature (body temperature ≥ 38°C), body temperature ≤ 36°C, reduced vigilance (Glasgow Coma Scale < 15), reported pain (numeric rating scale ≥ 1), crackles upon auscultation, wheezing upon auscultation, emergency department findings: crackles upon auscultation, wheezing upon auscultation, silent lung upon auscultation, and lower extremity edema. Detailed results of logistic regressions are shown in S2 Table.
Fig 5.
Hospital mortality and misdiagnoses by the PEMT.
Fig 5 presents hospital mortality rates for the most frequent discharge diagnoses as well as the number of out-of-hospital misdiagnosed cases in lethal outcomes. PEMT: physician-staffed emergency medical team; COPD: chronic obstructive pulmonary disease.
Table 2.
Predictors of hospital mortality.