Multicultural Presentation of Chest Pain to the ED

Multicultural Presentation of Chest Pain to the ED

To demonstrate differences in clinical outcomes between CALD (Culturally And Linguistically Diverse) and non-CALD CP patients presenting to Liverpool ED over a two-week period (n=258) through a prospective period prevalence study to provide an initial epidemiology data of Liverpool ED.

Method
Extraction and linkage of administrative and clinical data from ED FirstNet®, Hospital PowerChart® software and paper records analysed using R v3.5.1. Main outcomes included: ED patients’ epidemiology, degree of illness described by triage observation values, diagnostic and imaging investigations, medication utilisation, ED discharge diagnosis, length of stay (LOS). The time between the patient’s ED arrival to when they first saw an ED doctor, had diagnostic and imaging investigations ordered and medication administered was also measured.

Results
There were 158 (61.24%) CALD and 100 (38.75%) non-CALD patients. CALD patients had a significantly (p<0.0001) longer ED LOS than non-CALD patients (median 278.5 vs 263 mins). Overall, CALD patients were older (p<0.0001), presented with more abnormal vital signs at triage (p<0.0001), received more frequent diagnostic and imaging investigations and faster medication administration than non-CALD patients.

Conclusion
This pilot study found differences in many aspects of chest pain presentation between the two patient groups. CALD patients were older, presented with more abnormal vital signs at triage, received more frequent diagnostic and imaging investigations, and more rapid medication and stayed longer in the ED than non-CALD patients. A longer study duration with greater recruitment numbers would greatly add to the limited literature on this topic.