Comparison of outcomes\xa0in emergency department patients with suspected cardiac chest pain: two-centre prospective observational\xa0study in Southern China

Huilin Jiang,Colin A Graham,Peiyi Lin,Kevin K C Hung,Timothy H Rainer,Xiaohui Chen,Junrong Mo,Min Li,Yunmei Li

doi:10.1186/s12872-018-0814-4

Abstract

BackgroundHong Kong (HK) and Guangzhou (GZ) are cities in China with different healthcare systems. This study aimed to compare 30-day and 6-month mortality and characteristics of patients with suspected cardiac chest pain admitted to two emergency departments (ED) in HK and GZ.MethodsA prospective observational study enrolled patients with suspected cardiac chest pain presenting to EDs in the Prince of Wales Hospital (PWH), HK and the Second Affiliated Hospital of Guangzhou Medical University (AHGZMU),GZ. The primary outcome was 30-day and 6-month mortality.ResultsIn total, 996 patients were recruited, 407 cases from GZ and 589 cases from HK.The 30-day and 6-month mortality of chest patients were 3.7% and 4.7% in GZand 0.3% and 1.9% in HK, respectively. Serum creatinine level (Cr) was an independent factor for 30-day mortality whilst Cr and systolic blood pressure (SBP) were independent factors for 6-month mortality. In Cox regression analysis, unadjusted and adjusted hazard ratios for 30-day and 6-month mortality in GZ were significantly increased.ConclusionThe 30-day and 6-month mortality of patients with suspected cardiac chest pain in Guangzhou were higher than in Hong Kong due to due to different baseline clinical characteristics of patients and different distributions of diagnoses, which were associated with different healthcare systems. Serum creatinine and SBP were independent factors for 30-day and 6-month mortality.

Highlights

Hong Kong (HK) and Guangzhou (GZ) are cities in China with different healthcare systems
Backgroud Chest pain is a common chief complaint of patients presenting to emergency departments (ED) globally, and it places a huge burden on ED services [1,2,3]
The challenge for clinicians is the dual danger of discharging patients at potential high risk and the clinical pressure of EDs crowded with low risk patients

Summary

Objectives

This study aimed to compare 30-day and 6-month mortality and characteristics of patients with suspected cardiac chest pain admitted to two emergency departments (ED) in HK and GZ. The objective of the study was to compare 30-day and 6-month outcomes of patients with suspected cardiac chest pain presenting to two EDs in HK and GZ, and contributory factors of outcomes. We aimed to recruit an extra 30% in case of unforeseen circumstances and at least 230 (230 × 1.3 = 299) patients were required per group

Methods

Results

Discussion

Conclusion