TY - JOUR AU - Clark R. AU - Hyun K. AU - Wechkunanukul K. AU - Grantham H. AU - Teubner D. AB -

BACKGROUND: To date there has been limited published data presenting the characteristics and timeliness of the management in an Emergency Department (ED) for culturally and linguistically diverse (CALD) patients presenting with chest pain. This study aimed to describe the presenting characteristics and processing times for CALD patients with chest pain compared to the Australian-born population, and current guidelines. METHODS: This study was a cross sectional analysis of a cohort of patients who presented with chest pain to the metropolitan hospital between 1 July 2012 and 30 June 2014. RESULTS: Of the total study population (n=6640), 1241 (18.7%) were CALD and 5399 (81.3%) were Australian-born. CALD patients were significantly older than Australian-born patients (mean age 62 vs 56years, p<0.001). There were no differences in the proportion of patients who had central chest pain (74.9% vs 75.7%, p=0.526); ambulance utilisation (41.7% vs 41.1%, p=0.697); and time to initial treatment in ED (21 vs 22min, p=0.375). However, CALD patients spent a significantly longer total time in ED (5.4 vs 4.3h, p<0.001). There was no difference in guideline concordance between the two groups with low rates of 12.5% vs 13%, p=0.556. Nonetheless, CALD patients were 22% (95% CI, 0.65, 0.95, p=0.015) less likely to receive the guideline management for chest pain. CONCLUSIONS: The initial emergency care was equally provided to all patients in the context of a low rate of concordance with three chest pain related standards from the two guidelines. Nonetheless, CALD patients spent a longer time in ED compared to the Australian-born group.

AD - School of Nursing and Midwifery, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia. Electronic address: kannikar.w@flinders.edu.au.
Paramedic Department, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia. Electronic address: hugh.grantham@flinders.edu.au.
Paramedic Department, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia. Electronic address: david.teubner@flinders.edu.au.
The George Institute for Global Health, Cardiovascular division, Sydney Medical School, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, Camperdown, NSW 2050, Australia. Electronic address: khyun@georgeinstitute.org.au.
School of Nursing and Midwifery, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia. Electronic address: robyn.clark@flinders.edu.au. AN - 27404505 BT - International Journal of Cardiology DP - NLM ET - 2016/07/13 LA - Eng LB - AUS
CDV
FY16 N1 - Wechkunanukul, Kannikar
Grantham, Hugh
Teubner, David
Hyun, Karice K
Clark, Robyn A
Int J Cardiol. 2016 Jun 28;220:901-908. doi: 10.1016/j.ijcard.2016.06.244. N2 -

BACKGROUND: To date there has been limited published data presenting the characteristics and timeliness of the management in an Emergency Department (ED) for culturally and linguistically diverse (CALD) patients presenting with chest pain. This study aimed to describe the presenting characteristics and processing times for CALD patients with chest pain compared to the Australian-born population, and current guidelines. METHODS: This study was a cross sectional analysis of a cohort of patients who presented with chest pain to the metropolitan hospital between 1 July 2012 and 30 June 2014. RESULTS: Of the total study population (n=6640), 1241 (18.7%) were CALD and 5399 (81.3%) were Australian-born. CALD patients were significantly older than Australian-born patients (mean age 62 vs 56years, p<0.001). There were no differences in the proportion of patients who had central chest pain (74.9% vs 75.7%, p=0.526); ambulance utilisation (41.7% vs 41.1%, p=0.697); and time to initial treatment in ED (21 vs 22min, p=0.375). However, CALD patients spent a significantly longer total time in ED (5.4 vs 4.3h, p<0.001). There was no difference in guideline concordance between the two groups with low rates of 12.5% vs 13%, p=0.556. Nonetheless, CALD patients were 22% (95% CI, 0.65, 0.95, p=0.015) less likely to receive the guideline management for chest pain. CONCLUSIONS: The initial emergency care was equally provided to all patients in the context of a low rate of concordance with three chest pain related standards from the two guidelines. Nonetheless, CALD patients spent a longer time in ED compared to the Australian-born group.

PY - 2016 SN - 1874-1754 (Electronic)
0167-5273 (Linking) SP - 901 EP - 908 T2 - International Journal of Cardiology TI - Presenting characteristics and processing times for culturally and linguistically diverse (CALD) patients with chest pain in an emergency department: Time, Ethnicity, and Delay (TED) Study II VL - 220 Y2 - FY16 ER -