| アブストラクト | BACKGROUND: Chest pain is a common symptom that presents the primary care physician with a complex diagnostic and therapeutic challenge. AIMS: To evaluate the natural history and management of patients diagnosed with chest pain of unspecified type or origin in primary care. DESIGN: Population-based case-control study. METHODS: The study included 13,740 patients with a first diagnosis of unspecified chest pain and 20,000 age- and sex-matched controls identified from the UK General Practice Research Database. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using unconditional logistic regression. Risk estimates were adjusted for age, sex and number of physician visits. RESULTS: The incidence of a new diagnosis of chest pain was 15.5 per 1000 person-years and increased with age, particularly in men. The risk of a chest pain diagnosis was greatest in patients with prior diagnoses of coronary heart disease (OR: 7.1; 95% CI: 6.1-8.2) and gastroesophageal reflux disease (OR: 2.0; 95% CI: 1.7-2.3). In the year after diagnosis, chest pain patients were more likely than controls to be newly diagnosed with coronary heart disease (OR: 14.9; 95% CI: 12.7-17.4) and heart failure (OR: 4.7; 95% CI: 3.6-6.1). A new diagnosis of chest pain was associated with an increased risk of death in the following year (RR: 2.3; 95% CI: 1.9-2.8). CONCLUSIONS: Some causes of chest pain are underdiagnosed in primary care. This is of particular consequence for the minority of chest pain patients with cardiac disease. |
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| ジャーナル名 | Family practice |
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| Pubmed追加日 | 2006/2/8 |
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| 投稿者 | Ruigomez, Ana; Rodriguez, Luis Alberto Garcia; Wallander, Mari-Ann; Johansson, Saga; Jones, Roger |
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| 組織名 | Centro Espanol de Investigacion Farmacoepidemiologica (CEIFE), Madrid, Spain.;aruigomez@ceife.es |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/16461444/ |
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