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Differences between Chest Pain Observation Service Patients and Admitted “Rule‐out Myocardial Infarction” Patients
Author(s) -
Dallara John,
Severance Harry W.,
Davis Barbara,
Schulz Gail
Publication year - 1997
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.1997.tb03762.x
Subject(s) - medicine , chest pain , myocardial infarction , emergency department , angina , unstable angina , coronary artery disease , retrospective cohort study , emergency medicine , physical therapy , cardiology , psychiatry
Objective: To compare and contrast the patient characteristics of ED patients at low risk for acute cardiac ischemia who were assigned to a chest pain observation service vs those admitted to a monitored inpatient bed for “rule‐out acute myocardial infarction” (R/O MI). Methods: This was a retrospective, cross‐sectional comparison of adult patients considered at relatively low risk for cardiac ischemia and who were evaluated in 1 of 2 settings: a short‐term observation service and an inpatient monitored bed. All patients had an ED final diagnosis of “chest pain,” “R/O MI,” or “unstable angina” during the 7‐month study period. Demographic features and presenting clinical features were examined as a function of site of patient evaluation. Results: Of 531 study patients, 265 (50%) were assigned to the observation service. Younger age (OR = 1.75, 95% CI 1.26, 2.44, for each decrement of 20 years), the complaint of “chest pain” (OR = 2.35, 95% CI 1.34, 4.12), and the absence of prior known coronary artery disease (OR = 1.64, 95% CI 1.13, 2.38) were the principal independent factors associated with assignment to a chest pain observation service bed. Conclusions: Patients evaluated in a chest pain observation service appear to have different clinical characteristics than other individuals admitted to a monitored inpatient bed for “R/O MI.” Investigators should address differences in clinical characteristics when making outcome comparisons between these 2 patient groups.