Abstract 17277: Trends of Emergency Department Visits for Non Specific Chest Pain in USA: Analysis of National Emergency Department Sample Database From 2006 to 2013
Background: Non-specific chest pain (NSCP), or chest pain without an ischemic etiology, is fifth most common reason for Emergency Department (ED) visits in USA. At present, there are no comprehensive or universal guidelines for the optimal management of NSCP. Many of these patients may have pre-existing coronary artery disease (CAD), and concern often exists for an atypical presentation of ischemic pain. Given these concerns, patients presenting with NSCP account for a significant amount of heath-care resources. We aimed to look at national trends in ED visits and hospitalizations for NSCP.
Methods: We used Nationwide Emergency Department Sample (NEDS) from 2006 through 2013 to identify NSCP related ED visits using Clinical Classifications Software code 102 (includes ICD 9 codes 786.50-52, 786.59) as the first-listed diagnosis. The NEDS is the largest all-payer ED-based database with discharge data from 134 million ED visits per year for 947 hospitals located in 30 States.
Results: From 2006 to 2013, there was a 20.6% increase in ED visits with a principal discharge diagnosis of NSCP (3,736,502 vs. 4,506,337, p <0.001), while the percentage of patients admitted to the hospital decreased significantly from 19% to 7.83% (p <0.001). There was no change in associated mortality. Females presented more commonly with NSCP than males (55% vs 45%, p <0.001). The majority of patients presenting to the ED were 45-64 years of age, while the majority of admitted patients were over the age of 85 years. Private insurance continued to be the largest payer, followed by Medicare and then Medicaid.
Conclusions: Despite increased ED visits for NSCP in the recent years, the number of admissions has significantly decreased. These trends likely represent better risk stratification in ED and efficacious use of observation units. The results show a promising trend towards the reduction of NSCP associated health-care costs.
Author Disclosures: V. Anand: None. C. Alraies: None. M. Schnaus: None. G. Raveendran: None.
- © 2016 by American Heart Association, Inc.