ABSTRACT: The differential diagnosis of chest pain in the emergency department (ED) is broad, but the ability of the physician to distinguish between life-threatening and benign situations is Limited.
(1) To evaluate the in-hospital major adverse cardiac events (MACE) among patients admitted to the hospital for chest pain and their five years mortality rate. (2) To find factors in the ED which influence the short- and Long-term prognosis.
This is a retrospective cohort study. All patients admitted to the hospital only for chest pain, in a five months period, were identified. In-hospital MACE and five years mortality rates were recorded and evaluated in respect to the demographic and personal history of the patients and to tests performed in the emergency department.
The MACE rate was Less than 10%. In-hospital mortality was 0.46%. People who had in-hospital MACE were older, with typical chest pain, higher blood CPK level within the normal range, and ST depression on ECG in the ED. The five-year mortality rate was 13.6%. MortaLity was higher among women, older people with past MI, diabetics and in patients with lower hemoglobin and higher creatinine Levels at the ED.
In this group of ED patients with chest pain the MACE rate is small, and mostly appears in older patients with typical chest pain, higher CPK Levels within the normal range and ST depression on ECG. Long term prognosis depended on age, history of diabetes meLlitus and the blood hemoglobin level at the ED.
Harefuah 05/2012; 151(5):266-9, 320, 319.