PMID- 25635195
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20150130
LR  - 20200930
IS  - 1865-1372 (Print)
IS  - 1865-1380 (Electronic)
IS  - 1865-1372 (Linking)
VI  - 7
DP  - 2014
TI  - Retrospective study of elderly frequent attenders presenting with chest pain at 
      emergency department.
PG  - 35
LID - 10.1186/s12245-014-0035-2 [doi]
AB  - BACKGROUND: The aims of the study were to identify the characteristics of elderly 
      frequent attenders to the emergency department (ED) presenting with chest pain 
      and to assess the 1-year prognosis for developing adverse cardiac events. 
      FINDINGS: Patients over 75 years old, with four or more attendances to the ED 
      between 1 January 2010 and 31 December 2010 with at least one attendance due to 
      chest pain, were selected from a database. Data was collected on demographic 
      details, visit history, disposition and admission outcomes. Each patient was 
      followed up for 12 months after the index episode via the hospital electronic 
      registry for adverse cardiac outcome. Adverse cardiac outcomes included death 
      from cardiac event, acute myocardial infarction (ST elevation myocardial 
      infarction (STEMI)/non-ST elevation myocardial infarction (NSTEMI)) or unstable 
      angina. A total of 158 patients with 4 or more visits to the ED accounted for 290 
      visits with chest pain during 2010. There is a high prevalence of coronary risk 
      factors in this cohort (hypertension 92.4%, hyperlipidaemia 65.2%, diabetes 49.4% 
      and smoking 26.6%). The hospital admission rate was also high at 83.5%. Over the 
      ensuing 12 months, 8 patients died of a primary cardiac event and a further 29 
      patients developed 36 non-fatal cardiac events. We could not establish any 
      significant relationship between increase in adverse cardiac outcome and 
      individual risk factors or even two or more risk factors (P = 0.0572). Patients 
      with two or more attendances with chest pain were more likely to develop adverse 
      cardiac outcome (P = 0.0068). CONCLUSIONS: Elderly frequent attenders to the ED, 
      who present with chest pain, have more cardiac risk factors and are more likely 
      to develop adverse coronary outcomes if they re-attend with chest pain.
FAU - Zarisfi, Faraz
AU  - Zarisfi F
AD  - Department of Emergency Medicine, Singapore General Hospital, Outram Road, 
      Singapore 169608, Singapore.
FAU - Hong, Qi En
AU  - Hong QE
AD  - Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge 
      Road, Singapore 119228, Singapore.
FAU - Seah, Pauline See Joon
AU  - Seah PS
AD  - Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge 
      Road, Singapore 119228, Singapore.
FAU - Li, Huihua
AU  - Li H
AD  - Health Services Research Unit, Division of Research, Singapore General Hospital, 
      226 Outram Road Blk A Level 2, Singapore 169039, Singapore.
FAU - Yap, Susan
AU  - Yap S
AD  - Department of Emergency Medicine, Singapore General Hospital, Outram Road, 
      Singapore 169608, Singapore.
FAU - Ong, Marcus Eng Hock
AU  - Ong ME
AD  - Department of Emergency Medicine, Singapore General Hospital, Outram Road, 
      Singapore 169608, Singapore.
LA  - eng
PT  - Journal Article
DEP - 20140912
PL  - England
TA  - Int J Emerg Med
JT  - International journal of emergency medicine
JID - 101469435
PMC - PMC4306066
OTO - NOTNLM
OT  - Chest pain
OT  - Elderly
OT  - Emergency department
OT  - Frequent attenders
EDAT- 2015/01/31 06:00
MHDA- 2015/01/31 06:01
PMCR- 2014/09/12
CRDT- 2015/01/31 06:00
PHST- 2014/01/08 00:00 [received]
PHST- 2014/09/01 00:00 [accepted]
PHST- 2015/01/31 06:00 [entrez]
PHST- 2015/01/31 06:00 [pubmed]
PHST- 2015/01/31 06:01 [medline]
PHST- 2014/09/12 00:00 [pmc-release]
AID - s12245-014-0035-2 [pii]
AID - 10.1186/s12245-014-0035-2 [doi]
PST - epublish
SO  - Int J Emerg Med. 2014 Sep 12;7:35. doi: 10.1186/s12245-014-0035-2. eCollection 
      2014.