Effect of gender on the emergency department evaluation of patients with chest pain.

OBJECTIVE

To assess chest pain evaluation as reflected in the documentation of the evaluation process for women vs men in one emergency department (ED).

METHODS

In this retrospective case series, patient charts were reviewed for documentation in accordance with a clinical policy for chest pain evaluation. Patient demographics and the frequencies of inclusion of the following items were determined: five descriptors of chest pain, associated symptoms, risk factors for coronary artery disease, receipt of physical examination, and receipt of ECG.

RESULTS

Over a three-month period, 132 men and 150 women were evaluated for chest pain and entered in the study. There was no significant difference in age between men and women overall, but in the subgroup of patients who were admitted to the hospital, the women were significantly older than the men by an average of five years (p = 0.04). Fifty-five percent of all the patients were admitted to the hospital. The men were admitted to the hospital significantly more often than were the women (p = 0.01), with a relative risk of admission for women vs men 0.76 (95% CI = 0.62-0.94). There was no significant difference between the men and the women for any of the process of evaluation items in the overall group or in the hospital-admission and release-home subgroups.

CONCLUSION

The authors' findings do not support the existence of a gender difference in ED chest pain evaluations, as reflected by documentation of the evaluation process. However, men were more likely to be admitted to the hospital for evaluation of coronary artery disease than were women.