title: Inequalities in the early treatment of women and men with acute chest pain?
abstract: OBJECTIVE
  The aim of this study was to identify sex differences in the early chain of care for patients with chest pain.
  
  
  METHODS
  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.
  
  
  METHODS
  Data were retrospectively collected from ambulance and medical records and electrocardiogram (ECG), echocardiography, and laboratory databases.
  
  
  RESULTS
  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.
  
  
  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.affiliation: Institution of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Göteborg, Sweden. annica.ravn-fischer@vgregion.se
authors.forename: Annica
authors.initials: A
authors.lastname: Ravn-Fischer
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlsson
authors.forename: Marco
authors.initials: M
authors.lastname: Santos
authors.forename: Bo
authors.initials: B
authors.lastname: Bergman
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
authors.forename: Per
authors.initials: P
authors.lastname: Johanson
mesh_terms: D002637:Chest Pain / Q000175:diagnosis / Q000628:therapy*; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D004452:Echocardiography / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors