Prevalence of musculoskeletal chest pain in the emergency department: a systematic review and meta-analysis

Abstract

Objectives: Our objective was to systematically review and meta-analyse relevant studies to determine the prevalence of musculoskeletal chest pain in the emergency department.

Methods: This review was constructed while confirming to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed, Cochrane Library, SCOPUS, Science Direct, and OVID were systematically searched from their inception to January 19, 2020, to identify observational studies, where the prevalence of musculoskeletal causes of chest pain was reported in isolation or in combination with other causes or could be calculated from the available data.

Results: A meta-analysis of the nine included studies, having a total of 14,743 participants, showed the global pooled prevalence of musculoskeletal chest pain in the emergency department to be 16% (10-22%) [I²=99.24%]. The pooled prevalence for the European continent was 17% (9-25%) [I²=99.51%] and that for the urban areas was 13% (7-19%) [I²=99.00%].

Conclusions: This review provides a reliable estimate of the prevalence of musculoskeletal chest pain in the emergency department. More studies providing age and gender-specific data for the prevalence of musculoskeletal chest pain in the emergency department should be carried out. A paucity of such data from rural areas also needs to be addressed in future research work. The prevalence values from this study will be useful in the application of Bayesian reasoning utilised in diagnosing patients, where the process of Bayesian arguing begins by knowing pre-test probabilities of different differential diagnosis, in this case that of musculoskeletal chest pain in the emergency department.

Keywords: chest pain; emergency service, hospital; meta-analysis; musculoskeletal chest pain; prevalence; systematic review.