[从性别角度看急诊科胸痛就诊患者的就诊经历和结果]。

M. F. Grande-Ratti, María C Llamedo, Agustina B Pires, María V Giuffre, Brenda N Garrido, Agustina Saldarini, Pedro Touzas, Bernardo Martínez, Ignacio M Bluro
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引用次数: 0

摘要

目的临床实践指南建议胸痛患者在进入急诊科的前 10 分钟内进行心电图检查,并警告女性患者可能会被误诊。方法一项在急诊科进行的观察性和回顾性研究,研究对象为 2021 年胸痛科收治的成年患者。与女性相比,男性更年轻(60 岁对 65 岁),超重较少(17.18% 对 22.16%),曾入住过冠心病科(12% 对 7%)。在心电图表现(91% 对 90%)、心电图时间(中位数 4.1 分钟对 4.5 分钟)或护理延迟(中位数 25 分钟对 26 分钟)方面,没有观察到性别差异。在医疗资源方面,男性接受了更多的生物标志物检查:肌钙蛋白(63% 对 55%;几率比 [OR]:1.35;95% 置信区间 [95%CI]:1.10-1.67)和肌酸磷酸激酶(24.8% 对 19.1%),接受更多阿司匹林(6.7% 对 3.1%)、硝酸盐/亚硝酸盐(6% 对 3%)和住院治疗(17.18% 对 10.50%;OR:1.76;95% 置信区间;1.30-2.40)。在 206 名住院患者中,112 人最终诊断为急性冠状动脉综合征(54%),男性多于女性(81 对 31)。结论性别并不影响心前区疼痛的护理、诊断和治疗时间,突出了医院护理的质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Gender perspective in the care experience and in the results of patients who consult for chest pain in an emergency department].
Objective Clinical practice guidelines suggest performing an electrocardiogram (EKG) in patients with chest pain within the first 10 minutes in the emergency department, warning about subdiagnosis in women. Possible differences based on sex were analyzed. Method An observational and retrospective study in an Emergency Department, with adult patients admitted to the Chest Pain Unit in 2021. Results There were 1,469 patients, of whom 774 were men (52.7%). The men were younger (60 vs. 65 years), were less overweight (17.18 vs. 22.16%), and had more previous admissions to the Coronary Unit (12 vs. 7%), compared to women. No gender differences were observed in EKG performance (91 vs. 90%), EKG time (median 4.1 vs. 4.5 minutes), or delay in care attention (median 25 vs. 26 minutes). In terms of healthcare resources, men underwent more biomarkers: troponins (63 vs. 55%; odds ratio [OR]: 1.35; 95% confidence interval [95%CI]: 1.10-1.67) and creatine phosphokinase (24.8 vs. 19.1%), received more aspirin (6.7 vs. 3.1%), nitrates/nitrites (6 vs. 3%), and hospitalization (17.18 vs. 10.50%; OR: 1.76; 95%CI; 1.30-2.40). Of 206 hospitalized, 112 had a final diagnosis of acute coronary syndrome (54%), more men than women (81 vs. 31). There were no significant differences in revascularization time, medication schedule at discharge, hospital stay, or mortality. Conclusions Gender did not affect precordial pain care, diagnosis, and treatment times, highlighting the quality of hospital care.
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