Table 2.
Clinical Care and Outcomes for Patients with Chest Pain According to Risk Status
| High Risk (n = 1327) | Low Risk (n = 5756) | P value | |
|---|---|---|---|
| Outpatient-based care and outcomes | |||
| Evaluation | |||
| Electrocardiogram | 666 (50) | 2,472 (43) | <0.001 |
| Cardiac stress test | 220 (17) | 569 (10) | <0.001 |
| Positive test result | 9 (4) | 21 (4) | 0.84 |
| Diagnoses considered | |||
| Respiratory infection/asthma | 393 (30) | 2,081 (36) | <0.001 |
| Musculoskeletal pain | 345 (26) | 1,679 (29) | 0.02 |
| Angina/potential coronary ischemia | 328 (25) | 817 (14) | <0.001 |
| Gastroesophageal reflux/ heartburn | 180 (14) | 960 (17) | 0.01 |
| Anxiety | 61 (5) | 419 (7) | <0.001 |
| Atypical pain | 48 (4) | 270 (5) | 0.09 |
| Pulmonary embolism | 14 (1) | 69 (1) | 0.78 |
| Treatment | |||
| Aspirin | 247 (19) | 408 (7) | <0.001 |
| Inhaled bronchodilator | 213 (16) | 1,159 (20) | <0.001 |
| Nonsteroidal anti-inflammatory | 193 (15) | 1,278 (22) | <0.001 |
| Narcotic | 171 (13) | 712 (12) | 0.61 |
| Proton pump inhibitor/ H2 blocker | 161 (12) | 842 (15) | 0.02 |
| Beta blocker | 57 (4) | 97 (2) | <0.001 |
| Nitrate | 41 (3) | 39 (1) | <0.001 |
| Follow up care | |||
| Home | 1,207 (91) | 5,524 (96) | <0.001 |
| Emergency department* | 141(11) | 312 (5) | <0.001 |
| Hospitalized* | 93 (7) | 155 (3) | <0.001 |
| Hospital-based care and outcomes† | (n = 141) | (n = 312) | |
| Evaluation | |||
| Cardiac stress test | 59 (42) | 116 (37) | 0.30 |
| Cardiac catheterization | 22 (16) | 24 (8) | 0.03 |
| Diagnoses established | |||
| Acute myocardial infarction | 14 (11) | 12 (4) | <0.001 |
| Pericarditis | 0 (0) | 4 (1) | 0.32 |
| Pulmonary embolism | 3 (2) | 8 (3) | 1.0 |
| Treatment | |||
| Coronary angioplasty | 10 (7) | 12 (4) | 0.16 |
| Coronary artery bypass surgery | 4 (3) | 2 (1) | 0.08 |
*Within 30 days of index primary care visit
†Among patients evaluated in the emergency department