Comparison of presenting features, diagnostic tools, hospital outcomes, and quality of care indicators in older (>65 years) to younger, men to women, and diabetics to nondiabetics with acute chest pain triaged in the emergency department.
In a total of 4,843 consecutive patients admitted to an emergency department (ED) with acute chest pain over a 1-year period, presenting features, diagnostic tools, hospital outcomes, and quality-of-care indicators were compared between older (n = 1,781) and younger (n = 3,062) patients, men (n = 3,095) and women (n = 1,748), and diabetics (n = 856) and nondiabetics (n = 3,987). The results showed that after critical pathway implementation, there was an increase in the use of evidence-based treatment strategies in the ED and improved outcomes in older patients, women, and diabetics, with no more differences in the length of ED stay, diagnostic accuracy for myocardial infarction in the ED, door-to-thrombolysis time, and door-to-balloon time compared with younger patients, men, and nondiabetics.
Pelliccia
Francesco
F
Department of Cardioscience, San Camillo Hospital, Rome, Italy. f.pelliccia@mclink.it
Cartoni
Domenico
D
Verde
Monica
M
Salvini
Paolo
P
Petrolati
Sandro
S
Mercuro
Giuseppe
G
Tanzi
Pietro
P
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis; D002637:Chest Pain / Q000175:diagnosis*; D019091:Critical Pathways; D003925:Diabetic Angiopathies / Q000175:diagnosis; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005080:Exercise Test; D005260:Female; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000188:drug therapy; D010043:Outcome and Process Assessment, Health Care; D011787:Quality of Health Care; D018570:Risk Assessment; D015912:Thrombolytic Therapy; D014218:Triage