This July 1, 2016 JAMA study looked at the chief complaint of nontraumatic chest pain to see how commonly it was life threatening. The study used the National Hospital Ambulatory Medical Care Survey database to assess the accuracy of diagnoses.
The study determined that 5.5% of ER patients are diagnosed with 1 of 6 life threatening conditions. (acute coronary syndrome, aortic dissection, pulmonary embolism, tension pneumothorax, esophageal rupture, and perforated peptic ulcer)
Renee Hsia, MD, an emergency department physician and director of Health Policy Studies at the University of California, San Francisco, and colleagues analyzed a database that includes details from a sampling of US emergency department visits. They focused on 10,907 patient records from 2005 to 2011 for chest pain not due to trauma.
The researchers found also found that 57% of the patients were discharged, 0.4% died in the hospital or emergency department. The most common diagnosis for chest pain was “nonspecific chest pain.” This occurred in more than 5 out of 10 patients examined for chest pain.
This is an interesting study but may somewhat underestimate the number of patients with life threatening causes as there was no long term follow up on these patients as to their ultimate diagnoses.
Hsia RY, Hale Z, Tabas JA. A national study of the prevalence of life-threatening diagnoses in patients with chest pain. JAMA Intern Med. 2016;176(7):1029-1032; doi: 10.1001/jamainternmed.2016.2498