Inequalities in the early treatment of women and men with acute chest pain?

Am J Emerg Med. 2012 Oct;30(8):1515-21. doi: 10.1016/j.ajem.2011.12.020. Epub 2012 Mar 3.


Purpose: The aim of this study was to identify sex differences in the early chain of care for patients with chest pain.

Design: This is a retrospective study performed at 3 centers including all patients admitted to the emergency department because of chest pain, during a 3-month period in 2008, in the municipality of Göteborg. Chest pain or discomfort in the chest was the only inclusion criterion. There were no exclusion criteria.

Data sources: Data were retrospectively collected from ambulance and medical records and electrocardiogram (ECG), echocardiography, and laboratory databases.

Main findings: A total of 2588 visits (1248 women and 1340 men) made by 2393 patients were included. When adjusting for baseline variables, female sex was significantly associated with a prolonged delay time (defined as above median) between (a) admission to hospital and admission to a hospital ward (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.25-2.03), (b) first physical contact and first dose of aspirin (OR, 2.22; 95% CI, 1.30-3.82), and (c) admission to hospital and coronary angiography (OR, 2.50; 95% CI, 1.29-5.13). Delay time to the first ECG recording did not differ significantly between women and men.

Principal conclusions: Among patients hospitalized due to chest pain, when adjusting for differences at baseline, female sex was associated with a prolonged delay time until admission to a hospital ward, to administration of aspirin, and to performing a coronary angiography. There was no difference in delay to the first ECG recording.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chest Pain / diagnosis
  • Chest Pain / therapy*
  • Delayed Diagnosis / statistics & numerical data
  • Echocardiography / statistics & numerical data
  • Electrocardiography / statistics & numerical data
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Healthcare Disparities* / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sex Factors
  • Sweden / epidemiology
  • Time Factors