EFFECT OF GENDER ON THE EMERGENCY DEPARTMENT EVALUATION OF PATIENTS WITH CHEST PAIN

Objective: To assess chest pain evaluation as reflected in the documen tation of the evaluation process for women vs men in one emergency dep artment (ED). Methods: In this retrospective case series, patient char ts were reviewed for documentation in accordance with a clinical polic y for chest pain evaluation. Patient demographics and the frequencies of inclusion of the following items were determined: five descriptors of chest pain, associated symptoms, risk factors for coronary artery d isease, receipt of physical examination, and receipt of EGG. Results: Over a three-month period, 132 men and 150 women were evaluated for ch est pain and entered in the study. There was no significant difference in age between the men and the women overall, but in the subgroup of patients who were admitted to the hospital, the women were significant ly older than the men by an average of five years (p = 0.04). Fifty-fi ve percent of all the patients were admitted to the hospital. The men were admitted to the hospital significantly more often than were the w omen (p = 0.01), with a relative risk of admission for women vs men of 0.76 (95% CI = 0.62-0.94). There was no significant difference betwee n the men and the women for any of the process of evaluation items in the overall group or in the hospital-admission and release-home subgro ups. Conclusion: The authors' findings do not support the existence of a gender difference in ED chest pain evaluations, as reflected by doc umentation of the evaluation process. However, men were more likely to be admitted to the hospital for evaluation of coronary artery disease than were women.