Svansdottir Erla, Hreggvidsdottir Sesselja, Sigurdardottir Bjorg, Benedikz Elisabet, Andersen Karl, Karlsson Hrobjartur Darri
Department of Quality and Patient Safety, Landspítali University Hospital.
Department of Psychology, University of Iceland.
Laeknabladid. 2018 Feb;104(2):71-77. doi: 10.17992/lbl.2018.02.172.
An estimated 50-75% of visits to cardiac emergency departments are due to chest pain which is non-cardiac in nature (non-cardiac chest pain (NCCP). This study evaluates the prevalence of NCCP in the emergency departments at Landspitali, and assesses its association with continued chest-pain post discharge, mental well--being and the information-provision provided to NCCP patients during hospitalization.
Participants were 390 patients (18-65 years) presenting with chest pain to the cardiac emergency or the general emergency department at Landspitali from October 2015-May 2016. Measurements included questionnaires assessing somatic symptoms, mental well-being and quality of life, and questions regarding continued chest-pain and information-provision during hospitalization.
In total 72% of participants (282) were considered having NCCP while 24% (92) had cardiac disease. NCCP patients experienced a similar burden of somatic and depressive symptoms, but slightly more anxiety and mental distress than cardiac patients. Equal proportions (60%) of NCCP and cardiac patients reported having experienced chestpain post discharge. Continued chest-pain was, however, associated with greater anxiety (β=0.18, p<0.001) and depression (β=0.18, p<0.003) among NCCP patients. Thirty percent of NCCP patients lacked instructions of how to respond to continued chest-pain and only 40% received information regarding other possible causes of chest pain.
NCCP was prevalent among patients presenting to emergency departments at Landspitali. The majority of NCCP patients experienced continued chest-pain after discharge, and such pain experience was associated with mental distress. A third of NCCP patients lacked information about possible causes for the pain and advice about coping with symptoms.
估计有50 - 75%因胸痛前往心脏科急诊科就诊的病例，其胸痛本质上是非心脏性的（非心脏性胸痛，NCCP）。本研究评估了冰岛国家大学医院急诊科非心脏性胸痛的患病率，并评估其与出院后持续胸痛、心理健康以及住院期间向非心脏性胸痛患者提供的信息之间的关联。
研究对象为2015年10月至2016年5月期间，因胸痛前往冰岛国家大学医院心脏科急诊科或综合急诊科就诊的390名患者（年龄在18 - 65岁之间）。测量内容包括评估躯体症状、心理健康和生活质量的问卷，以及关于出院后持续胸痛和住院期间信息提供情况的问题。
共有72%的参与者（282人）被认为患有非心脏性胸痛，而24%（92人）患有心脏病。非心脏性胸痛患者经历了类似的躯体和抑郁症状负担，但比心脏病患者略多一些焦虑和精神痛苦。非心脏性胸痛患者和心脏病患者中，报告出院后经历过胸痛的比例相同（均为60%）。然而，在非心脏性胸痛患者中，持续胸痛与更高的焦虑（β = 0.18，p < 0.001）和抑郁（β = 0.18，p < 0.003）相关。30%的非心脏性胸痛患者缺乏应对持续胸痛的指导，只有40%的患者收到了关于胸痛其他可能原因的信息。
在冰岛国家大学医院急诊科就诊的患者中，非心脏性胸痛很常见。大多数非心脏性胸痛患者出院后仍有持续胸痛，且这种疼痛经历与精神痛苦有关。三分之一的非心脏性胸痛患者缺乏关于疼痛可能原因的信息以及应对症状的建议。
