Most ER visits for chest pain are not life-threatening, study finds

Most visits to the emergency department for chest pain are not life-threatening, according to a new study, so emergency physicians may not need to utilize significant diagnostic testing.

The study, published in JAMA Internal Medicine, examined data from nearly 11,000 patient records, representing 42 million patient visits to the ER over the course of seven years where the primary symptom was chest pain, and found that only 5.5 percent of visits led to a serious diagnosis.

Chest pain is the second most common cause of visits to the emergency department, according to the study’s announcement. “Because chest pain is a characteristic of several life-threatening conditions and the risks of missing these diagnoses are high, clinicians may overestimate the probability of these conditions,” lead study author Renee Hsia, M.D., a professor of emergency medicine and health policy at UC San Francisco, said in the announcement.

Hsia said it is imperative that emergency department physicians establish pre-testing screenings and probabilities to avoid subjecting patients to unneeded tests and examinations. As healthcare costs increase, the authors wrote, patient outcomes are improved when wasteful tests are eliminated.

A 2014 survey found that 75 percent of doctors think their peers order unneeded tests and procedures, and inaccurate, unreliable testing can spike costs, FierceHealthcare previously reported.

The UCSF study took its data from the National hospital Ambulatory Medical Care Survey, according to the announcement. The most common diagnosis found was nonspecific chest pain--noted in about 52 percent of patients--and the prevalence of serious diagnoses increased with age.

- view the study
- here’s the announcement