Sex/gender bias in the management of chest pain in ambulatory care.

Details

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State: Public
Version: Final published version
Serval ID
serval:BIB_3E098A92E2EF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Sex/gender bias in the management of chest pain in ambulatory care.
Journal
Women's health
Author(s)
Clerc Liaudat C., Vaucher P., De Francesco T., Jaunin-Stalder N., Herzig L., Verdon F., Favrat B., Locatelli I., Clair C.
ISSN
1745-5065 (Electronic)
ISSN-L
1745-5057
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
14
Pages
1745506518805641
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Cardiovascular diseases (CVD) are the main cause of death worldwide and despite a higher prevalence in men, mortality from CVD is higher among women. Few studies have assessed sex differences in chest pain management in ambulatory care. The objective of this post hoc analysis of data from a prospective cohort study was to assess sex differences in the management of chest pain in ambulatory care.
We used data from the Thoracic Pain in Community cohort study that was realized in 58 primary care practices and one university ambulatory clinic in Switzerland.
In total, 672 consecutive patients aged over 16 years attending a primary care practice or ambulatory care clinic with a complaint of chest pain were included between February and June 2001. Their mean age was 55.2 years and 52.5% were women.
The main outcome was the proportion of patients referred to a cardiologist at 12 months follow-up. A panel of primary care physicians assessed the final diagnosis retained for chest pain at 12 months.
The prevalence of chest pain of cardiovascular origin (n = 108, 16.1%) was similar for men and women (17.5% vs 14.8%, respectively, p = 0.4). Men with chest pain were 2.5 times more likely to be referred to a cardiologist than women (16.6% vs 7.4%, odds ratio: 2.49, 95% confidence interval: 1.52-4.09). After adjustment for the patients' age and cardiovascular disease risk factors, the estimates did not significantly change (odds ratio: 2.30, 95% confidence interval: 1.30-3.78).
Although the same proportion of women and men present with a chest pain of cardiovascular origin in ambulatory care, there is a strong sex bias in their management. These data suggest that effort must be made to assure equity between men and women in medical care.
Keywords
Adult, Aged, Attitude to Health, Chest Pain/diagnosis, Chest Pain/epidemiology, Cohort Studies, Coronary Disease/diagnosis, Coronary Disease/epidemiology, Female, Humans, Inpatients/statistics & numerical data, Male, Medical History Taking/statistics & numerical data, Middle Aged, Primary Health Care/statistics & numerical data, Prospective Studies, Referral and Consultation/statistics & numerical data, Sex Factors, Women's Health/statistics & numerical data, Young Adult, ambulatory care, chest pain, sex differences, sex/gender bias
Pubmed
Web of science
Open Access
Yes
Create date
07/11/2018 13:50
Last modification date
20/08/2019 14:34
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