ArticleBMC family practice2014
Management of chest pain: a prospective study from Norwegian out-of-hours primary care.
Article in BMC family practice, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 20 citations in OpenAlex.
- Article
- Cost-effectiveness of a rule-out algorithm of acute myocardial infarction in low-risk patients: emergency primary care versus hospital setting.BMC health services research · 2022Article
- Article
- Reasons for acute referrals to hospital from general practitioners and out-of-hours doctors in Norway: a registry-based observational study.BMC health services research · 2022Observational
- Gender-stratified analyses of symptoms associated with acute coronary syndrome in telephone triage: a cross-sectional study.BMJ open · 2021Article
- Article
- Accuracy of telephone triage in primary care patients with chest discomfort: a cross-sectional study.Open heart · 2020Article
- Pre-hospital One-Hour Troponin in a Low-Prevalence Population of Acute Coronary Syndrome: OUT-ACS study.Open heart · 2020Observational
- Observational
- Role of out of hours primary care service in limiting inappropriate access to emergency department.Internal and emergency medicine · 2018Article
- Chest pain syndromes are associated with high rates of recidivism and costs in young United States Veterans.BMC family practice · 2015Article
- Towards a greater appreciation of manual therapy challenges in the thoracic spine.The Journal of manual & manipulative therapy · 2015Article
- Chest pain out-of-hours - an interview study of primary care physicians' diagnostic approach, tolerance of risk and attitudes to hospital admission.BMC family practice · 2014Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChest pain is a common diagnostic challenge in primary care and diagnostic measures are often aimed at confirming or ruling out acute ischaemic heart disease. The aim of this study was to investigate management of patients with chest pain out-of-hours, including the use of ECG and laboratory tests, assessment of severity of illness, and the physicians' decisions on treatment and admittance to hospital.
methodsData were registered prospectively from four Norwegian casualty clinics. Data from structured telephone interviews with 100 physicians shortly after a consultation with a patient presenting at the casualty clinic with "chest pain" were analysed.
resultsA total of 832 patients with chest pain were registered. The first 100 patients (corresponding doctor-patient pairs) were included in the study according to the predefined inclusion criteria. Median age of included patients was 46 years, men constituted 58%. An ECG was taken in 92 of the patients. Of the 24 patients categorised to acute level of response, 15 had a NACA-score indicating a potentially or definitely life-threatening medical situation. 50 of the patients were admitted to a hospital for further management, of which 43 were thought to have ischaemic heart disease. Musculoskeletal pain was the second most common cause of pain (n = 22). Otherwise the patients were thought to have a variety of conditions, most of them managed at a primary care level.
conclusionsPatients with chest pain presenting at out-of-hours services in Norway are investigated for acute heart disease, but less than half are admitted to hospital for probable acute coronary syndrome, and only a minority is given emergency treatment for acute coronary syndrome. A wide variety of other diagnoses are suggested by the doctors for patients presenting with chest pain. Deciding the appropriate level of response for such patients is a difficult task, and both over- and under-triage probably occur in out-of-hours primary care.
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