Background
Methods
Study population
Study variables
Statistical analysis
Multiple imputation for missing data
Sensitivity analyses
Assumptions used in the sensitivity analyses
Results
Characteristics | Age 50 years or younger | Age 51 years or older | ||
---|---|---|---|---|
Male N = 647 | Female N = 175 | Male N = 2646 | Female N = 1391 | |
Age, mean (SD) | 43.4 (6.1) | 43.6 (5.5) | 67.9 (11.0) | 73.8 (11.4)** |
Socioeconomic statusa, % | ||||
Low | 43.0 | 42.3 | 38.4 | 37.8 |
Middle | 28.7 | 26.3 | 28.5 | 26.7 |
High | 28.3 | 31.4 | 33.1 | 35.5 |
Born in Australia, % | 51.3 | 66.3** | 43.6 | 48.2* |
Arrived by ambulance, % | 54.7 | 52.6 | 69.9 | 76.1** |
Arrived within 60 min of onset of symptoms, % | 21.2 | 10.3** | 13.3 | 9.9* |
Triage urgencyb, % | ||||
Resuscitation /Emergency | 77.1 | 65.1 | 67.0 | 53.0 |
All else | 22.9 | 34.9** | 33.0 | 47.0** |
Presenting symptom, % | ||||
Chest pain | 86.2 | 84.0 | 80.1 | 71.2 |
Arrhythmia | 6.0 | 5.1 | 7.4 | 7.6 |
Other (e.g., musculoskeletal, SOB) | 5.6 | 9.1 | 10.7 | 18.8 |
Referred due to abnormal finding | 2.2 | 1.7 | 1.8 | 2.4** |
Pulse pressure, mean (SD) | 67.5 (20.8) | 63.1 (25.6)* | 76.3 (25.2) | 80.1 (28.0)** |
Heart rate, mean (SD) | 81.1 (14.4) | 85.5 (17.4)** | 81.9 (14.7) | 85.0 (17.1)** |
Time from arrival till examined by a physician in minutes, mean (SD) | 30.9 (52.9) | 49.1 (61.9)** | 46.1 (65.9) | 64.5 (79.4)** |
Discharged from ED to: % | ||||
CCU or ICU or operating theatre | 78.8 | 69.1 | 70.7 | 60.3 |
Medical ward | 21.2 | 30.9** | 29.3 | 39.7** |
Age 50 years or younger | Age 51 or older | |||
---|---|---|---|---|
Male | Female | Male | Female | |
Chest pain | 20.1 | 10.2 | 13.1 | 9.8 |
Arrhythmia | 46.2 | 11.1 | 24.5 | 18.9 |
Atypical symptoms (e.g., musculoskeletal pain, shortness of breath) | 16.7 | 12.5 | 8.2 | 7.3 |
Referred to emergency department due to abnormal findings | 7.1 | 0.0 | 6.3 | 5.9 |
All | 21.2 | 10.3 | 13.3 | 9.9 |
Age 50 years or younger | Age 51 or older | |||
---|---|---|---|---|
Male | Female | Male | Female | |
Chest pain | 79.0 | 70.1* | 74.6 | 67.0** |
Arrhythmia | 87.2 | 66.7 | 68.9 | 43.4** |
Atypical symptoms (e.g., musculoskeletal pain, shortness of breath) | 63.9 | 56.3 | 44.7 | 43.3 |
Referred to emergency department due to abnormal findings | 85.7 | 100.0a
| 60.4 | 50.0 |
All | 78.7 | 69.1* | 70.7 | 60.3** |
Male | Female | ||||||||
---|---|---|---|---|---|---|---|---|---|
CCU or ICU | Medical ward | CCU or ICU | Medical ward | ||||||
Age groups | Standard Population | Death rate % | Expected # death | Death rate % | Expected # death | Death rate % | Expected # death | Death rate % | Expected # death |
All ages | 4859 | ||||||||
18–54 | 1223 | 0.53 | 6.5 | 0.97 | 11.9 | 1.10 | 13.5 | 2.70 | 33.0 |
55–65 | 1245 | 1.78 | 22.2 | 1.84 | 22.9 | 1.72 | 21.4 | 1.52 | 18.9 |
66–78 | 1289 | 2.77 | 35.7 | 3.65 | 47.0 | 2.95 | 38.0 | 3.97 | 51.2 |
79 + | 1102 | 5.80 | 63.9 | 6.67 | 73.5 | 7.08 | 78.0 | 12.03 | 132.6 |
Total number of deaths expected | 128 | 155 | 151 | 236 | |||||
Crude rates | 2.1 % | 3.5 % | 3.3 % | 7.8 % | |||||
Age adjusted rates | 128/4859 = 2.6 % | 155/4859 = 3.2 % | 151/4859 = 3.1 % | 236/4859 = 4.9 % |
Covariate | Odds ratio, 95 % CI |
P value |
---|---|---|
Age categories (tertiles) | ||
18–58 years (reference) | 1.00 | |
59–74 years | 2.3 (1.3–4.3) | 0.006 |
75 year or more | 5.0 (2.8–9.1) | <0.001 |
Female sex | 1.6 (1.1–2.3) | 0.007 |
Socioeconomic statusb
| ||
Low tertile (reference) | 1.00 | |
Middle tertile | 0.8 (0.5–1.3) | 0.4 |
High tertile | 0.8 (0.6–1.2) | 0.3 |
Born in Australia | 0.8 (0.6–1.1) | 0.2 |
Chest pain as main presenting symptom | 0.3 (0.2–0.4) | <0.001 |
Arrival in the ED within 60 min of onset of symptoms | 0.9 (0.6–1.6) | 0.9 |
Arrival in ambulance | 3.9 (2.0–7.8) | <0.001 |
Triage classification of urgency | ||
Non-urgent presentations (reference) | 1.00 | |
Emergency presentations/resuscitation needed | 3.0 (1.8–4.9) | <0.001 |
Admitted to CCU or ICU | 0.5 (0.3–0.7) | <0.001 |
Time from arrival in the ED to examination by physician (continuous variable) | 1.0 (0.9–1.0) | 0.9 |