Long-Term Prognosis of Low-Risk Women Presenting to the Emergency Department with Chest Pain - 01/11/17
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Abstract |
Background |
Prognosis of low-risk women presenting to the emergency department (ED) with chest pain has not been clarified. We assessed early and long-term outcomes of such patients and determined the need for predischarge testing.
Methods |
Retrospective assessment of consecutive low-risk women presenting to the ED with chest pain evaluated in a chest pain unit (CPU). Criteria of low risk: age ≤51 years; no history of cardiovascular disease, diabetes, or smoking; negative initial electrocardiogram (ECG); and cardiac troponin. Predischarge testing (treadmill or stress imaging) was performed at the discretion of the CPU attending physician.
Results |
The study group comprised 214 consecutive women. Predischarge testing was performed in 142 patients (66%, age 43.9 years) and 72 patients (34%, age 43.1 years) had no predischarge testing. Predischarge testing comprised exercise treadmill (n = 102, 72%) or stress imaging (n = 40, 28%). Length of stay with no predischarge testing was 4.1 hours, compared with 8.6 hours with predischarge testing (P = .04). There were no cardiovascular events in the index presentation; during a 5-year interval (100% follow-up), there were 2 cardiovascular events (fatal heart failure, 1 patient; fatal stroke, 1 patient [total, 2/214, 0.93%]).
Conclusions |
Low-risk women presenting to the ED with chest pain have an excellent short- and long-term prognosis. A majority of patients did not receive predischarge testing, and their length of stay was reduced by >50% compared with those with predischarge testing. These findings suggest that such patients may not require predischarge testing for disposition from a CPU, which can reduce length of stay, decrease cost, and improve resource utilization.
Le texte complet de cet article est disponible en PDF.Keywords : Chest pain, Chest pain unit, Low-risk women, Predischarge testing, Prognosis
Plan
Funding: None. |
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Conflict of Interest: All authors declare that we have no conflicts of interest. |
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Authorship: All authors had access to the data and participated in writing the manuscript. |
Vol 130 - N° 11
P. 1313-1317 - novembre 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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