Journal of Emergencies, Trauma, and Shock
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Year : 2022  |  Volume : 15  |  Issue : 1  |  Page : 35-40

Accuracy of emergency department chest pain patients' reporting of coronary disease history

1 Department of Emergency Medicine, CHRISTUS Health/Texas A and M Health Science Center, Corpus Christi, TX, USA
2 Department of Mathematics, Texas A and M University-Corpus Christi, Corpus Christi, TX, USA

Correspondence Address:
Dr. Peter B Richman
Department of Emergency Medicine, CHRISTUS Health/Texas A and M Health Science Center, 600 Elizabeth Street, Corpus Christi, Tx 78404
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JETS.JETS_78_20

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Introduction: History is an important component of emergency department risk stratification for chest pain patients. We hypothesized that a significant portion of patients would not be able to accurately report their history of coronary artery disease (CAD) and diagnostic testing. Methods: We prospectively enrolled a convenience sample of a cohort of adult ED patients with a chief complaint of chest pain. They completed a structured survey that included questions regarding prior testing for CAD and cardiac history. Study authors performed a structured chart review within the electronic medical record for our 6-hospital system. Results of testing for CAD, cardiac interventions, and chart diagnoses of CAD/acute myocardial infarction (AMI) were recorded. Categorical data were analyzed by Chi-square and continuous data by logistic regression. Results: About 196 patients were enrolled; mean age 57 ± 15 years, 48% female, 67% Hispanic, 50% income <$20,000/year. About 43% (95% confidence interval [CI] 35%–51%) of patients stated that they did not have CAD, yet medical records indicated that they were CAD+. With increasing age, patients were more likely to accurately report the absence of CAD (P < 0.001). There was no association between patients reporting no CAD, but CAD+ in records with respect to the following characteristics: female gender (P = 0.37), Hispanic race (P = 0.73), income (P = 0.41), less than or equal to high school education (P = 0.11), and private insurance (P = 0.71). For patients with prior AMI, 7.2% (95% CI 2.7%–11%) reported no prior history of AMI. Conclusions: Within our study group from a predominantly poor, Hispanic population, patients had a poor recall for the presence of CAD in their medical history.

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