Short-Term Outcomes and Sex-Based Analysis Following Chest Pain Presentations to Emergency Departments in Western...

To describe emergency department (ED) chest pain presentations and outcomes, and sex-based differences in Western Australia.

We conducted a retrospective cohort study using linked ED, hospital, morbidity, mortality, and pathology data from the Western Australian Data Linkage System as part of the AUS-MOCHA project. We included the index presentation for adults presenting with non-traumatic chest pain between January 2016 and October 2020. Comorbidities were identified via a 10-year lookback of linked morbidity data. The primary outcome was diagnosis of acute coronary syndrome (ACS) or all-cause death within 30 days of ED discharge.

The study included 64,404 patients (mean age 54.8 years, 49.2% female). Most presented 'out-of-hours' (62.2%) and received an Australasian Triage Scale (ATS) Category of 2 (85.2%). Females were less likely to receive an ATS 1 and more likely to receive ATS 3 or 4. This difference persisted after propensity matching. However, males were more comorbid and had a higher incidence of 30-day outcomes than females. There was no statistically significant difference in ATS categories between males and females when assessing a propensity matched cohort of only those who experienced 30-day outcome. Among patients discharged home from the ED, 0.4% were diagnosed with ACS and 0.1% died within 30 days.

Patients who were discharged home from EDs had a low risk of subsequent ACS or death within 30 days. Females were triaged less urgently than males, yet had lower 30-day ACS and death rates. Among patients with 30-day outcomes, triage scores did not differ by sex.