Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107-5004, USA.
Am J Emerg Med. 2010 Mar;28(3):318-24. doi: 10.1016/j.ajem.2008.12.021.
The study aimed to determine whether aspirin therapy was differentially administered according to race, sex, or age in patients with undifferentiated chest pain who presented to an urban academic emergency department.
This was a prospective observational cohort study of patients older than 24 years who presented with chest pain between July 1999 and March 2002. Patients were grouped according to 30-day final diagnosis: acute myocardial infarction AMI, unstable angina USA, and non-acute coronary syndrome (ACS) chest pain. Data were analyzed using Fisher exact test and relative risk regression using the Gaussian estimating equation.
There were 4478 patient visits, of which 4470 (99.8%) had complete information. Mean age was 52.2 +/- 15.8 years. Blacks were 70.1% (n = 3135), whites 26.3% (n = 1175), and other 3.6% (n = 159). Women comprised 59.0% (n = 2639) of the patients. Aspirin therapy differed by race, sex, age, and final diagnosis. Patients who received aspirin were more likely to be white (60% vs 54%, P = .0009) or have an ACS diagnosis (82% vs 50%, P < .0001). By final diagnosis, there were no race, sex, or age differences for AMI or USA (P > .05). There were significant sex and age differences for non-ACS chest pain patients: men (53% vs 48% women, P = .0009) and older patients (>55 years, 60% vs 44% younger, P < .0001) had higher aspirin therapy due to administration to the patients with non-ACS chest pain.
For patients with undifferentiated chest pain, overall race, sex, and age differences were explained by higher rates of aspirin administered to older men with non-ACS chest pain.
本研究旨在确定在就诊于城市学术急诊部的非胸痛患者中，是否根据种族、性别或年龄给予不同的阿司匹林治疗。
这是一项对 1999 年 7 月至 2002 年 3 月期间就诊的年龄大于 24 岁的胸痛患者进行的前瞻性观察队列研究。根据 30 天最终诊断将患者分组：急性心肌梗死（AMI）、不稳定型心绞痛（USA）和非急性冠脉综合征（ACS）胸痛。使用 Fisher 确切检验和使用高斯估计方程的相对风险回归分析数据。
共有 4478 次就诊，其中 4470 次（99.8%）有完整信息。平均年龄为 52.2 ± 15.8 岁。黑人占 70.1%（n = 3135），白人占 26.3%（n = 1175），其他种族占 3.6%（n = 159）。女性占患者的 59.0%（n = 2639）。阿司匹林治疗因种族、性别、年龄和最终诊断而不同。接受阿司匹林治疗的患者更可能是白人（60%比 54%，P =.0009）或 ACS 诊断（82%比 50%，P <.0001）。根据最终诊断，AMI 或 USA 患者在种族、性别或年龄方面没有差异（P >.05）。非 ACS 胸痛患者的性别和年龄差异显著：男性（53%比女性 48%，P =.0009）和年龄较大的患者（>55 岁，60%比年龄较小的 44%，P <.0001）由于非 ACS 胸痛患者给予阿司匹林治疗的比例较高。
对于非胸痛患者，种族、性别和年龄的总体差异可归因于非 ACS 胸痛老年男性患者中阿司匹林使用率较高。
