Patients' sex and race are independent predictors of HEART score documentation by emergency medicine providers
| Autor: | Jenna Hakim, Erica Dunn, Rebecca Jeanmonod, Darin Agresti, Kate Arner, Michael Irick, Brian S. Kelly, Jennifer Irick, Ronald Check, Holly Stankewicz, Kylie Ridley |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Chest Pain Chest pain Logistic regression Risk Assessment Documentation Sex Factors Risk Factors Physicians Health care medicine Electronic Health Records Humans Medical History Taking Retrospective Studies business.industry Medical record Patient-centered outcomes Racial Groups Retrospective cohort study General Medicine Emergency department Middle Aged Logistic Models Emergency medicine Emergency Medicine Female medicine.symptom business Emergency Service Hospital |
| Zdroj: | The American journal of emergency medicine. 51 |
| ISSN: | 1532-8171 |
| Popis: | Introduction The HEART score is a widely used clinical decision tool that provides emergency providers with objective risk stratification for patients presenting to the emergency department (ED) with undifferentiated chest pain (CP). There is no data as to which patients undergo formal risk stratification with a HEART score, and whether patient demographics influence decisions to apply the HEART score. Our objective was to determine if sex or race independently predict documentation of patients' HEART scores in CP patients. Methods This is a retrospective cohort study of all patients with a chief complaint of CP who presented to EDs within a single health care system (11 EDs) from September 2018–January 2021. Charts were identified via query of the electronic medical record, and patient age, race, and sex were extracted. The presence or absence of documentation of a HEART score was also recorded. Patient race was categorized as white/non-white. Sex was categorized as male/female. Age was inputted as a continuous variable. We performed logistic regression to determine which variables were associated with documentation of a HEART score. Results 38,277 patients were included in the study. The median patient age was 51 with IQR 36–64, and 18,927 (47.5%) were male. HEART scores were documented in 24,181. Younger age, female sex, and non-white race were all independent predictors of not having HEART score risk stratification documented in the medical record. Conclusions Women and non-white patients are less likely to receive HEART score risk stratification when presenting with undifferentiated CP, even when controlling for patient age. Further studies should address whether this influences patient centered outcomes. |
| Databáze: | OpenAIRE |
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