# Short‐Term Outcomes and Sex‐Based Analysis Following Chest Pain Presentations to Emergency Departments in Western Australia—An AUS‐MOCHA Substudy

## TL;DR

This study examines chest pain emergency cases in Western Australia, finding that women are triaged less urgently but have lower 30-day risks of heart issues or death.

## Contribution

The study reveals sex-based triage differences and outcomes in chest pain emergency cases using linked health data.

## Key findings

- Females were triaged less urgently than males despite similar 30-day outcomes.
- Only 0.4% of discharged patients were diagnosed with ACS and 0.1% died within 30 days.
- Triage scores did not differ by sex among patients with 30-day outcomes.

## Abstract

To describe emergency department (ED) chest pain presentations and outcomes, and sex‐based differences in Western Australia.

We conducted a retrospective cohort study using linked ED, hospital, morbidity, mortality, and pathology data from the Western Australian Data Linkage System as part of the AUS‐MOCHA project. We included the index presentation for adults presenting with non‐traumatic chest pain between January 2016 and October 2020. Comorbidities were identified via a 10‐year lookback of linked morbidity data. The primary outcome was diagnosis of acute coronary syndrome (ACS) or all‐cause death within 30 days of ED discharge.

The study included 64,404 patients (mean age 54.8 years, 49.2% female). Most presented ‘out‐of‐hours’ (62.2%) and received an Australasian Triage Scale (ATS) Category of 2 (85.2%). Females were less likely to receive an ATS 1 and more likely to receive ATS 3 or 4. This difference persisted after propensity matching. However, males were more comorbid and had a higher incidence of 30‐day outcomes than females. There was no statistically significant difference in ATS categories between males and females when assessing a propensity matched cohort of only those who experienced 30‐day outcome. Among patients discharged home from the ED, 0.4% were diagnosed with ACS and 0.1% died within 30 days.

Patients who were discharged home from EDs had a low risk of subsequent ACS or death within 30 days. Females were triaged less urgently than males, yet had lower 30‐day ACS and death rates. Among patients with 30‐day outcomes, triage scores did not differ by sex.