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Hospitalised patients with unexplained chest pain: incidence and prognosis.
Egeland, G M; Akerkar, R; Kvåle, R; Sulo, G; Tell, G S; Bakken, I J; Ebbing, M.
Afiliación
  • Egeland GM; Division of Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway.
  • Akerkar R; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
  • Kvåle R; Division of Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway.
  • Sulo G; Division of Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway.
  • Tell GS; Department of Oncology, Haukeland University Hospital, Bergen, Norway.
  • Bakken IJ; Division of Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway.
  • Ebbing M; Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway.
J Intern Med ; 286(5): 562-572, 2019 11.
Article en En | MEDLINE | ID: mdl-31322304
BACKGROUND: The prognosis of unexplained chest pain patients provides valuable information for evaluation of health services. OBJECTIVE: To examine prognosis of unexplained chest pain. METHODS: Using data from in- and outpatient hospital visits in Norway of patients discharged with a main diagnosis of unexplained chest pain (ICD-10: R072-R074) in 2010-2012, the 1-year incidence of coronary heart disease (CHD), any cardio-vascular disease (CVD) and mortality was evaluated. Cases with prior 2-year history of CVD or chest pain were excluded. Cox proportional hazards evaluated outcomes by patient characteristics and standardized mortality ratios evaluated observed versus expected mortality. RESULTS: Of 59 569 patients identified (20-89 years of age), the majority (86%) were referred to hospital by out-of-hours emergency care centres. Subsequent CHD was noted for 12.5%, 19.5% and 25.0% of men and 7.2%, 11.0%, 14.0% of women aged 45-64, 65-74 and 75-89 years, respectively. The per cent of deaths attributed to CVD were greatest within the first 2 months of postdischarge. Total mortality rates (per 1000 person-years) were 6.6 in men and 4.7 in women aged 45-64 and 69.2 in men and 39.5 in women aged 75-89 years. Relative to the general population, mortality was 53% and 45% higher for men and women under 65 years of age, respectively, attributed primarily to non-CVD causes. CONCLUSION: Patients in Norway discharged with unexplained chest pain are an at-risk group in terms of incident CHD, any CVD and mortality, including non-CVD mortality during the first-year postdischarge. The results suggest that unexplained chest pain patients may benefit from greater healthcare coordination between medical disciplines.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor en el Pecho / Enfermedades Cardiovasculares / Hospitalización Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2019 Tipo del documento: Article País de afiliación: Noruega Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor en el Pecho / Enfermedades Cardiovasculares / Hospitalización Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2019 Tipo del documento: Article País de afiliación: Noruega Pais de publicación: Reino Unido