Study on clinical features and 30-day death-correlated risk factors for elderly patients with acute chest pain leading to emergency department visit

Objectives To investigate clinical features and the risk factors for 30-day death in elderly chest pain patients. Methods In the prospective study, 514 patients with acute chest pain leading to emergency department visit were selected from March 2012-August 2010 and grouped into elderly group (aged≥65 years, n=309) and non-elderly group (aged< 65 years, n=205). The patient's clinical data during 30-day follow-up period were recorded for analysis and comparison.Multivariate regression analysis was used to investigate the risk factors of death. Results Among 514 cases with acute chest pain, 30(5.8%)patients with all-cause death included 24 cases in group of 309 (7.8%) elderly patients and 6 (2.9%) cases in group of 205 non-elderly patients during 30 day follow-up period.Univariate regression analysis showed that female, low SBP, Killips’ classification ≥ Ⅱ, high level of serum troponin T and creatinine, coronary artery ischemia were more likely to died during 30 day follow-up period.And female and Killips’ classification ≥ Ⅱwere the independent factor for 30-day death in the elderly[OR: 3.55 (95%CI: 1.00-12.59) and 5.90 (95%CI: 1.31-26.63)]respectively. Conclusions Elderly patients with acute chest pain for first emergency department visit are at high risk for 30-day death.Female and cardiac function Killips’ classification ≥ Ⅱ, high levels of serum troponin T and creatinine and coronary artery ischemia are associated with 30-day death in patients with acute chest pain for first emergency visit.Female and Killips’ classification ≥ Ⅱare the independent risk factor for 30-day death. Key words: Chest pain; Death; Emergency department