Abstract
Objectives: To assess final diagnoses and mortality rates (30-day and 1-year) in patients requiring inhaled bronchodilators administered by ambulance personnel.
Methods: In a retrospective observational cohort study, patients experiencing respiratory distress and treated with inhaled bronchodilators in the prehospital setting within the Central Denmark Region during 2018-2019 were included.
Results: The study included 6,318 ambulance transports, comprising 3,686 cases of acute exacerbation of chronic obstructive pulmonary disease (AECOPD), 234 with community-acquired pneumonia (CAP), 320 with heart disease (HD), 233 adults with asthma, 1,674 with various other primary ICD-10 diagnoses (other ≥18 years), and 171 patients under 18 years. The 30-day mortality rate for all patients was 10.7% (95% CI 9.8-11.6), with zero deaths within 30 days among adults with asthma and those under 18. Excluding low mortality groups, AECOPD patients had the lowest 30-day mortality at 10.2% (95% CI 9.1-11.3), and HD patients the highest at 15.3% (95% CI 10.6-19.9). The 1-year overall mortality rate increased to 32.1% (95% CI 30.2-34.0), with mortality staying low for asthma and under-18 groups, while differences between other groups lessened and became insignificant.
Conclusions: Patients requiring inhaled bronchodilator treatment in ambulances exhibit notably high mortality rates at 30 days and 1 year, except for those with asthma or under 18. The need for prehospital bronchodilators could serve as a clear and unmistakable marker for moderate to severe respiratory distress, enabling early intervention.