Middleton Paul M, Wu Tammy Ll, Lee Riccardo Yih-Nan, Ren Shiquan, McLaws Mary-Louise
South Western Emergency Research Institute, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.
South Western Sydney Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.
Emerg Med Australas. 2021 Jun;33(3):508-516. doi: 10.1111/1742-6723.13681. Epub 2020 Nov 24.
To investigate differences in presenting patient characteristics, investigation, management and related outcomes between culturally and linguistically diverse (CALD) and non-CALD chest pain (CP) patients presenting to the ED.
A cohort study of 258 patients was enrolled on presentation to Liverpool Hospital ED with a complaint of CP over a 2-week period. Main outcomes included frequency and timeliness of diagnostic and radiological investigations, medication administered and ED length of stay. Administrative and clinical data were extracted and linked from Cerner EMR FirstNet®, PowerChart® and paper records.
There were 155 (60%) CALD and 103 (40%) non-CALD patients. CALD patients were older by 10 years (95% CI 4, 15; P < 0.0001). There were no significant differences in the number of pathology and imaging investigations carried out in each group, and similarly there were no significant differences in the number of patients administered analgesia or cardiac-specific medications. Neither group differed in their ED length of stay (median 280 vs 259.5 min; P = 0.79) or hospital admission rate (median 56% vs 55%, P = 0.8).
Both CALD and non-CALD ED CP patients had similar test ordering, medication administration and clinical outcomes, but this was in the context of CALD patients being 10 years older together with a small study sample size. A larger cohort, matched for age, would provide further insights into potentially important differences.
调查前往急诊科就诊的文化和语言背景多样（CALD）及非CALD胸痛（CP）患者在患者特征、检查、治疗及相关结局方面的差异。
一项队列研究纳入了258例患者，这些患者在为期2周的时间里因胸痛主诉前往利物浦医院急诊科就诊。主要结局包括诊断性和放射学检查的频率及及时性、用药情况以及急诊科留观时间。从Cerner EMR FirstNet®、PowerChart®及纸质记录中提取并关联行政和临床数据。
有155例（60%）CALD患者和103例（40%）非CALD患者。CALD患者年龄大10岁（95%可信区间4, 15；P < 0.0001）。两组进行的病理学和影像学检查数量无显著差异，同样，接受镇痛或心脏特异性药物治疗的患者数量也无显著差异。两组在急诊科留观时间（中位数280对259.5分钟；P = 0.79）或住院率（中位数56%对55%，P = 0.8）方面均无差异。
CALD和非CALD急诊科CP患者在检查医嘱、用药及临床结局方面相似，但这是在CALD患者年龄大10岁且研究样本量较小的背景下。一个年龄匹配的更大队列将为潜在的重要差异提供进一步见解。
