Finessi, Andrea

Mills, Aqiyl

Motorwala, Aarif

Rodriguez, Pura, MPH

Varella, Marcia, MD, MPH, PhD

English

DigitalCommons@Florida International University

Poster #25  Title: “The Association Between Race and the Frequency of Chest Computed Tomography in Patients who Present to the Emergency Department with Acute Chest Pain” Aarif Motorwala; Aqiyl Mills; Andrea Finessi; Pura Rodriguez, MPH; Marcia Varella, MD, MPH, PhD Category: Emergency Medicine; Health Disparities  Keywords: Racial Disparities; Use of Chest CT; Acute Chest Pain Evaluation  Introduction and Objective: Chest Computed Tomography (CT) has become the reference standard for distinguishing the cause of chest pain in acute settings, and as such, it should be offered to all patients that fit this criterion. We explored the frequency of chest CT use reported, comparing African Americans and Caucasians adults who presented with acute chest pain to Emergency Departments (ED) in the US from 2014-2018.   Methods: We performed secondary analysis of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Adults ≥18 years old who presented to the emergency department with acute chest pain were eligible. The independent variable was race of the individual (categorized as Black or White). The dependent variable was the use of chest Computer Tomography (CT) in the evaluation of acute chest pain at the ED. We excluded patients missing information about thoracic CT scan, adults with past medical history of coronary artery disease and myocardial infarction, race, or those reporting race other than black and white. Crude and adjusted odds ratio (with 95% confidence intervals) were obtained using logistic regression. Statistical significance was considered for p<0.05. Results: A total of 3,613 were assessed and of those 2585 (69.25%) were White and 1038 were black (30.75%). The overall percentage of CT use was 11.5% and 8.8 % for White and Black, respectively. The odds ratio for using chest CT in Black as compared to White patients were 0.75 95%CI 0.79-1.39 in the unadjusted model. After adjusting for patient’s sex, age, history of hypertension, hyperlipidemia, insurance, obesity, and diabetes mellitus these results remained not significant (OR=0.87 95%CI 0.62-1.23). Conclusions: Our results suggested no difference in CT use between Black and White patients presenting in the ED with chest pain. However, potential differences in access to care and income level were not accounted for. We suggest that further studies are performed controlling for socioeconomic factors as to confirm findings that disparities do not play a role in chest pain management in the ED in the US.  

The Association Between Race and the Frequency of Chest Computed Tomography in Patients who Present to the Emergency Department with Acute Chest Pain

https://digitalcommons.fiu.edu/cgi/viewcontent.cgi?article=1051&context=hwcom-student-research-symposium

The Association Between Race and the Frequency of Chest Computed Tomography in Patients who Present to the Emergency Department with Acute Chest Pain

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