Effect of gender on evidence-based practice for Australian patients with acute coronary syndrome

A retrospective multi-site study

Lisa Kuhn, Karen Page, Maryann Street, John Rolley, Julie Considine

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Early acute coronary syndrome (ACS) care occurs in the emergency department (ED). Death and disability from ACS are reduced with access to evidence-based ACS care. In this study, we aimed to explore if gender influenced access to ACS care.

METHODS: A retrospective descriptive study was conducted for 288 (50% women, n=144) randomly selected adults with ACS admitted via the ED to three tertiary public hospitals in Victoria, Australia from 1.1.2013 to 30.6.2015.

RESULTS: Compared with men, women were older (79 vs 75.5 years; p=0.009) less often allocated triage category 2 (58.3 vs 71.5%; p=0.026) and waited longer for their first electrocardiograph (18.5 vs 15min; p=0.001). Fewer women were admitted to coronary care units (52.4 vs 65.3%; p=0.023), but were more often admitted to general medicine units (39.6 vs 22.9%; p=0.003) than men. The median length of stay was 4days for both genders, but women were admitted for significantly more bed days than men (IQR 3-7 vs 2-5; p=0.005).

CONCLUSIONS: There were a number of gender differences in ED care for ACS and women were at greater risk of variation from evidence-based guidelines. Further research is needed to understand why gender differences exist in ED ACS care.

Original languageEnglish
Pages (from-to)63-68
Number of pages6
JournalAustralasian Emergency Nursing Journal
Volume20
Issue number2
DOIs
Publication statusPublished - May 2017
Externally publishedYes

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Evidence-Based Practice
Acute Coronary Syndrome
Hospital Emergency Service
Coronary Care Units
Victoria
Triage
Public Hospitals
Emergency Medical Services
Tertiary Care Centers
Length of Stay
Electrocardiography
Retrospective Studies
Medicine
Guidelines
Research

Cite this

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title = "Effect of gender on evidence-based practice for Australian patients with acute coronary syndrome: A retrospective multi-site study",
abstract = "BACKGROUND: Early acute coronary syndrome (ACS) care occurs in the emergency department (ED). Death and disability from ACS are reduced with access to evidence-based ACS care. In this study, we aimed to explore if gender influenced access to ACS care.METHODS: A retrospective descriptive study was conducted for 288 (50{\%} women, n=144) randomly selected adults with ACS admitted via the ED to three tertiary public hospitals in Victoria, Australia from 1.1.2013 to 30.6.2015.RESULTS: Compared with men, women were older (79 vs 75.5 years; p=0.009) less often allocated triage category 2 (58.3 vs 71.5{\%}; p=0.026) and waited longer for their first electrocardiograph (18.5 vs 15min; p=0.001). Fewer women were admitted to coronary care units (52.4 vs 65.3{\%}; p=0.023), but were more often admitted to general medicine units (39.6 vs 22.9{\%}; p=0.003) than men. The median length of stay was 4days for both genders, but women were admitted for significantly more bed days than men (IQR 3-7 vs 2-5; p=0.005).CONCLUSIONS: There were a number of gender differences in ED care for ACS and women were at greater risk of variation from evidence-based guidelines. Further research is needed to understand why gender differences exist in ED ACS care.",
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Effect of gender on evidence-based practice for Australian patients with acute coronary syndrome : A retrospective multi-site study. / Kuhn, Lisa; Page, Karen; Street, Maryann; Rolley, John; Considine, Julie.

In: Australasian Emergency Nursing Journal, Vol. 20, No. 2, 05.2017, p. 63-68.

Research output: Contribution to journalArticle

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AU - Kuhn, Lisa

AU - Page, Karen

AU - Street, Maryann

AU - Rolley, John

AU - Considine, Julie

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N2 - BACKGROUND: Early acute coronary syndrome (ACS) care occurs in the emergency department (ED). Death and disability from ACS are reduced with access to evidence-based ACS care. In this study, we aimed to explore if gender influenced access to ACS care.METHODS: A retrospective descriptive study was conducted for 288 (50% women, n=144) randomly selected adults with ACS admitted via the ED to three tertiary public hospitals in Victoria, Australia from 1.1.2013 to 30.6.2015.RESULTS: Compared with men, women were older (79 vs 75.5 years; p=0.009) less often allocated triage category 2 (58.3 vs 71.5%; p=0.026) and waited longer for their first electrocardiograph (18.5 vs 15min; p=0.001). Fewer women were admitted to coronary care units (52.4 vs 65.3%; p=0.023), but were more often admitted to general medicine units (39.6 vs 22.9%; p=0.003) than men. The median length of stay was 4days for both genders, but women were admitted for significantly more bed days than men (IQR 3-7 vs 2-5; p=0.005).CONCLUSIONS: There were a number of gender differences in ED care for ACS and women were at greater risk of variation from evidence-based guidelines. Further research is needed to understand why gender differences exist in ED ACS care.

AB - BACKGROUND: Early acute coronary syndrome (ACS) care occurs in the emergency department (ED). Death and disability from ACS are reduced with access to evidence-based ACS care. In this study, we aimed to explore if gender influenced access to ACS care.METHODS: A retrospective descriptive study was conducted for 288 (50% women, n=144) randomly selected adults with ACS admitted via the ED to three tertiary public hospitals in Victoria, Australia from 1.1.2013 to 30.6.2015.RESULTS: Compared with men, women were older (79 vs 75.5 years; p=0.009) less often allocated triage category 2 (58.3 vs 71.5%; p=0.026) and waited longer for their first electrocardiograph (18.5 vs 15min; p=0.001). Fewer women were admitted to coronary care units (52.4 vs 65.3%; p=0.023), but were more often admitted to general medicine units (39.6 vs 22.9%; p=0.003) than men. The median length of stay was 4days for both genders, but women were admitted for significantly more bed days than men (IQR 3-7 vs 2-5; p=0.005).CONCLUSIONS: There were a number of gender differences in ED care for ACS and women were at greater risk of variation from evidence-based guidelines. Further research is needed to understand why gender differences exist in ED ACS care.

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