Gender perspective in the care experience and in the results of patients who consult for chest pain in an emergency department

María F. Grande-Ratti, Central de Emergencias de Adultos, Hospital Italiano de Buenos Aires; Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires; CONICET (Consejo Nacional de Investigaciones Científicas y Técnicas); Instituto Universitario Hospital Italiano de Buenos Aires
María C. Llamedo, Instituto Universitario Hospital Italiano de Buenos Aires; Servicio de Cardiología, Hospital Italiano de Buenos Aires
Agustina B. Pires, Instituto Universitario Hospital Italiano de Buenos Aires; Servicio de Clínica Médica, Hospital Italiano de Buenos Aires
María V. Giuffre, Instituto Universitario Hospital Italiano de Buenos Aires; Servicio de Clínica Médica, Hospital Italiano de Buenos Aires
Brenda N. Garrido, Instituto Universitario Hospital Italiano de Buenos Aires; Servicio de Medicina Familiar y Comunitaria, Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
Agustina Saldarini, Instituto Universitario Hospital Italiano de Buenos Aires; Servicio de Clínica Médica, Hospital Italiano de Buenos Aires
Pedro Touzas, Instituto Universitario Hospital Italiano de Buenos Aires; Servicio de Cardiología, Hospital Italiano de Buenos Aires
Bernardo Martínez, Central de Emergencias de Adultos, Hospital Italiano de Buenos Aires; Servicio de Clínica Médica, Hospital Italiano de Buenos Aires
Ignacio M. Bluro, Central de Emergencias de Adultos, Hospital Italiano de Buenos Aires;; Servicio de Cardiología, Hospital Italiano de Buenos Aires

Objective: Clinical practice guidelines suggest performing an electrocardiogram (EKG) in patients with chest pain within the first 10 minutes in the emergency department, warning about subdiagnosis in women. Possible differences based on sex were analyzed. Method: An observational and retrospective study in an Emergency Department, with adult patients admitted to the Chest Pain Unit in 2021. Results: There were 1,469 patients, of whom 774 were men (52.7%). The men were younger (60 vs. 65 years), were less overweight (17.18 vs. 22.16%), and had more previous admissions to the Coronary Unit (12 vs. 7%), compared to women. No gender differences were observed in EKG performance (91 vs. 90%), EKG time (median 4.1 vs. 4.5 minutes), or delay in care attention (median 25 vs. 26 minutes). In terms of healthcare resources, men underwent more biomarkers: troponins (63 vs. 55%; odds ratio [OR]: 1.35; 95% confidence interval [95%CI]: 1.10-1.67) and creatine phosphokinase (24.8 vs. 19.1%), received more aspirin (6.7 vs. 3.1%), nitrates/nitrites (6 vs. 3%), and hospitalization (17.18 vs. 10.50%; OR: 1.76; 95%CI; 1.30-2.40). Of 206 hospitalized, 112 had a final diagnosis of acute coronary syndrome (54%), more men than women (81 vs. 31). There were no significant differences in revascularization time, medication schedule at discharge, hospital stay, or mortality. Conclusions: Gender did not affect precordial pain care, diagnosis, and treatment times, highlighting the quality of hospital care.

Keywords: Emergency Service. Hospital. Chest pain. Gender equity. Sexism. Argentina.