Characteristics of Patients Diagnosed with Acute Myocardial Infarction within a community health system
APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)
purpose: Characterize patients discharged with an AMI from four community hospitals and investigate the care pathways female patients receive in the Emergency Department (ED).
methods: We conducted a retrospective cohort study of all adult patients discharged with an AMI between October 2015 and March 2018. Additionally, we performed a retrospective chart review of adult female patients who came to the ED with a chief complaint suggestive of a cardiac event and compared their care pathways to age- and race-matched male controls.
results: Approximately 60% of the 3,729 AMI cases were male, and on average,significantly younger than females (72 vs 78, p-value=<0.001). Only 50% of females and 53% of males under 50 received orders for a cardiac consult. Among female cases under 50, 8% were African Americanand 2% were white (p-value=<0.001). Compared to white women under 50, African American women under 50 had higher rates of hyperlipidemia (50% vs 40%), hypertension (59% vs 40%), acute renal failure (27% vs 16%), and type 2 diabetes (41% vs 16%).
conclusion: Our results suggest the need for greater provider surveillance of African American women under the age of 50 presenting with symptoms of a cardiac event in the ED.
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