Inequalities in the early treatment of women and men with acute chest pain?
Journal article, 2012

Abstract PURPOSE: The aim of this study was to identify sex differences in the early chain of care for patients with chest pain. DESIGN: 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. DATA SOURCES: Data were retrospectively collected from ambulance and medical records and electrocardiogram (ECG), echocardiography, and laboratory databases. MAIN FINDINGS: 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. PRINCIPAL 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.


Annica Ravn-Fischer

University of Gothenburg

Thomas Karlsson

University of Gothenburg

Marco Santos

Chalmers, Technology Management and Economics, Quality Sciences

Bo Bergman

Chalmers, Technology Management and Economics, Quality Sciences

Johan Herlitz

University of Borås

Per Johanson

University of Gothenburg

American Journal of Emergency Medicine

0735-6757 (ISSN) 1532-8171 (eISSN)

Vol. 30 8 1515-1521

Subject Categories

Cardiac and Cardiovascular Systems





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3/8/2018 9