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Patients admitted to hospital with chest pain - Changes in a 20-year perspective.

Nguyen Dang Thang ; Björn Wilgot Karlson ; Bo Bergman (Institutionen för teknikens ekonomi och organisation, Industriell kvalitetsutveckling) ; Marco Santos ; Thomas Karlsson ; Ann Bengtson ; Per Johanson ; Araz Rawshani ; Johan Herlitz
International journal of cardiology (1874-1754). Vol. 166 (2013), 1, p. 141-146.
[Artikel, refereegranskad vetenskaplig]

OBJECTIVES: To describe the differences in characteristics and outcome between two consecutive series of patients admitted to hospital with chest pain in a 20-year perspective. Particular emphasis is placed on changes in outcome in relation to the initial electrocardiogram (ECG). SUBJECTS: In the two periods, 1986-1987 and 2008, all patients with chest pain admitted to the study hospitals in Gothenburg, Sweden, were included. RESULTS: Five thousand and sixteen patients were registered in a period of 21months in 1986-1987 and 2287 patients were registered during 3months in 2008. In a comparison of the two time periods, the age of chest pain patients was not significantly different (mean age 60.1±17.8years in 1986-1987 and 59.8±19.1years in 2008, p=0.50). There was a lower prevalence of previous angina pectoris, congestive heart failure and current smoking in the second period, whereas a history of acute myocardial infarction, hypertension and diabetes mellitus had become more prevalent. The use of cardio-protective drugs increased and ECG changes indicating acute myocardial ischemia on admission to hospital decreased. Length of hospitalisation was reduced from a median of 5days to 3days (p<0.0001). A significant decrease in 30-day and 1-year mortality was found (3.8% in 1986-1987 vs 2.0% in 2008 and 9.9% vs 6.3% respectively, p<0.0001 for both comparisons). CONCLUSIONS: During a period of 20years, the characteristics and outcome of patients admitted to hospital with chest pain changed. The most important changes were a lower prevalence of ECG signs indicating acute myocardial ischemia on admission, shorter hospitalisation time and a lower 30-day and 1-year mortality.

Nyckelord: Chest pain, Coronary heart disease, Myocardial infarction, Electrocardiography

Denna post skapades 2012-01-11. Senast ändrad 2016-08-25.
CPL Pubid: 152374


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Institutionen för teknikens ekonomi och organisation, Industriell kvalitetsutveckling (2005-2016)
Institutionen för vårdvetenskap och hälsa (GU)


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