Wilcox R G, Roland J M, Hampton J R
Br Med J (Clin Res Ed). 1981 Feb 7;282(6262):431-3. doi: 10.1136/bmj.282.6262.431.
All 662 patients admitted to the two coronary care units in Nottingham during 12 consecutive months were followed up prospectively for one year. At the time of discharge from hospital they were categorised according to set criteria into the following diagnostic groups: definite, probable, or possible myocardial infarction; ischaemia heart disease without infarction; chest pain ?cause; and other diagnoses. Eighty-nine patients (13% of admissions) were categorised as having chest pain ?cause. No deaths occurred among these patients during the observation period, although two were readmitted with myocardial infarction. Patients with chest pain ?cause had few problems during the year after admission, and at the end of that time 75% were in their original employment. Patients admitted with ischaemic heart disease had a similar death rate (between six weeks and one year after admission) to those with myocardial infarction, and only 36% were in their original employment one year after admission. Chest pain ?cause is a clinically useful diagnostic category to which patients may be allocated after only simple investigations.
对诺丁汉市两个冠心病监护病房连续12个月收治的所有662例患者进行了为期一年的前瞻性随访。出院时,根据既定标准将他们分为以下诊断组:确诊、疑似或可能的心肌梗死;无梗死的缺血性心脏病;胸痛-病因不明;以及其他诊断。89例患者(占入院患者的13%)被归类为胸痛-病因不明。在观察期内,这些患者中没有死亡病例,尽管有2例因心肌梗死再次入院。胸痛-病因不明的患者在入院后的一年中问题较少,到那时,75%的患者仍从事原来的工作。因缺血性心脏病入院的患者(入院后六周至一年)的死亡率与心肌梗死患者相似,入院一年后只有36%的患者仍从事原来的工作。胸痛-病因不明是一个临床上有用的诊断类别,只需进行简单检查即可对患者进行分类。