Table 3. Predictors of Receiving Cardiac Biomarker Testing in the ED.
| Characteristic | Odds Ratio (95% CI) | |
|---|---|---|
| Unadjusted | Adjusteda | |
| Age, per 10 y | 1.43 (1.40-1.47) | 1.22 (1.17-1.27) |
| Female sex | 0.95 (0.87-1.03) | 0.90 (0.81-1.01) |
| Race/ethnicity | ||
| White, non-Hispanic | 1 [Reference] | 1 [Reference] |
| Black, non-Hispanic | 0.90 (0.77-1.06) | 1.09 (0.89-1.34) |
| Other | 0.89 (0.74-1.07) | 1.01 (0.85-1.20) |
| Primary payer | ||
| Private insurance | 1 [Reference] | 1 [Reference] |
| Medicare | 2.44 (2.17-2.75) | 0.99 (0.81-1.20) |
| Medicaid | 0.78 (0.66-0.91) | 0.94 (0.79-1.13) |
| Other or unknown | 0.61 (0.51-0.74) | 0.83 (0.67-1.01) |
| Cardiovascular comorbidities, No. | ||
| 0 | 1 [Reference] | 1 [Reference] |
| 1 | 3.23 (2.90-3.59) | 1.14 (0.98-1.32) |
| 2-4 | 5.74 (4.69-7.02) | 1.11 (0.82-1.50) |
| Symptom of ACS | ||
| None | 1 [Reference] | 1 [Reference] |
| Atypical | 3.56 (3.21-3.96) | 1.79 (1.57-2.03) |
| Chest pain | 11.95 (10.08-14.17) | 5.62 (4.47-7.05) |
| Visit related to an injury or poisoning | 0.29 (0.27-0.32) | 0.64 (0.58-0.71) |
| Abnormal vital signs | 1.76 (1.62-1.90) | 1.02 (0.91-1.14) |
| Glasgow Coma Scale score <14 | 1.40 (0.83-2.34) | 0.83 (0.52-1.35) |
| Moderate or severe pain | 0.56 (0.51-0.62) | 0.67 (0.60-0.75) |
| Disposition status | ||
| Treat and release | 1 [Reference] | 1 [Reference] |
| Non–critical care unit | 7.32 (6.45-8.30) | 1.52 (1.32-1.73) |
| Critical care unit | 11.14 (8.95-13.85) | 1.71 (1.32-2.21) |
| Cardiovascular visit diagnosis | 8.07 (6.99-9.31) | 2.59 (2.15-3.11) |
| Other tests or services in the ED, No. | ||
| 0-5 | 1 [Reference] | 1 [Reference] |
| 6-10 | 21.70 (18.22-25.83) | 13.65 (11.41-16.32) |
| >10 | 76.20 (53.39-108.75) | 59.55 (39.23-90.40) |
| Emergent status by triage | 3.00 (2.54-3.54) | 1.06 (0.88-1.29) |
| Duration of ED visit >2 h | 5.98 (5.03-7.11) | 1.64 (1.38-1.95) |
| Region | ||
| Northeast | 1 [Reference] | 1 [Reference] |
| Midwest | 1.01 (0.72-1.41) | 1.16 (0.73-1.85) |
| South | 0.92 (0.68-1.25) | 1.07 (0.74-1.54) |
| West | 1.13 (0.77-1.65) | 1.67 (0.98-2.83) |
| Nonmetropolitan area | 0.66 (0.49-0.89) | 1.12 (0.78-1.63) |
| Hospital owner | ||
| Nonprofit | 1 [Reference] | 1 [Reference] |
| Government | 0.79 (0.61-1.02) | 0.98 (0.72-1.34) |
| Proprietary | 0.55 (0.34-0.88) | 0.74 (0.41-1.33) |
Abbreviations: ACS, acute coronary syndrome; ED, emergency department.
a
Weighted multivariable logistic regression model adjusted for the covariates listed above, accounting for the complex survey design.