Inequalities in the early treatment of women and men with acute chest pain?

Abstract

PURPOSE:

The aim of this study was to identify sex differences in the early chain of care for patients with chest pain.

DESIGN:

This is a retrospective study performed at 3 centers including all patients admitted to the emergency department because of chest pain, during a 3-month period in 2008, in the municipality of Göteborg. Chest pain or discomfort in the chest was the only inclusion criterion. There were no exclusion criteria.

DATA SOURCES:

Data were retrospectively collected from ambulance and medical records and electrocardiogram (ECG), echocardiography, and laboratory databases.

MAIN FINDINGS:

A total of 2588 visits (1248 women and 1340 men) made by 2393 patients were included. When adjusting for baseline variables, female sex was significantly associated with a prolonged delay time (defined as above median) between (a) admission to hospital and admission to a hospital ward (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.25-2.03), (b) first physical contact and first dose of aspirin (OR, 2.22; 95% CI, 1.30-3.82), and (c) admission to hospital and coronary angiography (OR, 2.50; 95% CI, 1.29-5.13). Delay time to the first ECG recording did not differ significantly between women and men.

PRINCIPAL CONCLUSIONS:

Among patients hospitalized due to chest pain, when adjusting for differences at baseline, female sex was associated with a prolonged delay time until admission to a hospital ward, to administration of aspirin, and to performing a coronary angiography. There was no difference in delay to the first ECG recording.

• Authors: Annica Ravn-Fischer, Thomas Karlsson, Marco Santos, Bo Bergman, Johan Herlitz, Per Johanson
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 30 Issue 8 Pg. 1515-21 (Oct 2012) ISSN: 1532-8171 [Electronic] United States
• PMID: 22386352 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Topics

• Chest Pain (diagnosis, therapy)
• Delayed Diagnosis (statistics & numerical data)
• Echocardiography (statistics & numerical data)
• Electrocardiography (statistics & numerical data)
• Emergency Service, Hospital (statistics & numerical data)
• Female
• Healthcare Disparities (statistics & numerical data)
• Hospitalization (statistics & numerical data)
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Sex Factors
• Sweden (epidemiology)
• Time Factors