Frequency of acute coronary events and characteristics of patients entering in a Unified emergency hospital admission system with a symptom of chest pain

1.UVOD Bol u prsima jedan je od najčešćih razloga za javljanje bolesnika u hitnu službu uz bolove u trbuhu i pogađa oko 20-40% populacije stanovništva tijekom života. Javnozdravstveni je problem te dijagnostički i terapijski izazov hitne medicine. 2.CILJ Prikazati učestalost akutnog koronarnog zbivanja, utvrditi demografske karakteristike i rizične čimbenike od kojih boluju ispitanici, analizirati okolnosti pojave boli u prsima te utvrditi ishod liječenja i konačnu dijagnozu prilikom otpusta/hospitalizacije. 3.METODE Istraživanje je provedeno pomoću podataka koji su prikupljeni iz bolničkog informacijskog sustava. U istraživanje su uključeni ispitanici koji su se javili u Objedinjeni hitni bolnički prijem, Opće bolnice Zabok i bolnice hrvatskih veterana, u razdoblju od 01.06.2020. do 01.04.2021. godine. Za statističku analizu korišten je statistički program R (inačica 4.0.2.). 4.REZULTATI Učestalost akutnog koronarnog sindroma iznosila je 13,77%. Većina ispitanika sa akutnim koronarnim zbivanjem su muškarci stariji od 60 godina, dok su u ostalih ispitanika podjednako zastupljena oba spola. Čak 82,6% svih ispitanika sa bolovima u prsima nije posjetilo izabranog liječnika prije dolaska u Objedinjeni hitni bolnički prijem (OHBP), a većina bolesnika sa akutnim koronarnim sindromom je koristila TIM1 hitne medicinske pomoći kao izabrani način dolaska. Trijažna kategorija 2 najčešće je dodijeljena bolesnicima sa koronarnim zbivanjem, a u ostalih se češće dodjeljuje trijažna kategorija 3. Hipertenzija i pušenje su u obje ispitivane skupine zastupljeni većom učestalošću, u odnosu na druge ispitivane čimbenike. Bolesnici sa akutnim koronarnim sindromom (AKS) najčešće navode pojavnost boli u prsima za vrijeme mirovanja, a ostali ispitanici jednakim omjerom prilikom obavljanja svakodnevnih aktivnosti i mirovanju. 39,62% ispitanika sa koronarnim sindromom kao najčešći pridruženi simptom navode bol u ruci, a bolesnici koji nisu razvili AKS navode otežano disanje. Od svih ispitanika, njih 75,58% je otpušteno kući, a 2 su umrla na OHBP-u. Konačne dijagnoze koje se najčešće pojavljuju su AKS, torakalni sindrom, neregulirani krvni tlak, nespecifična bol u prsima i gastritis. 5.ZAKLJUČAK Ispitanici u istraživanju su bolesnici sa bolovima u prsima. Više je muškaraca nego žena. Učestalost akutnog koronarnog sindroma je 13,77%. Najčešći rizični čimbenici od kojih boluju ispitanici su hipertenzija i pušenje. Od pridruženih simptoma javljaju se bol u ruci, otežano disanje, bol u trbuhu i ubrzan rad srca. Većina se ispitanika nakon obrade otpušta kući. Dijagnoza koja se najčešće postavlja u hitnoj službi je nespecifična bol u prsima, u čak 30,65% ispitanika.1. INTRODUCTION Chest pain is one of the most common reasons for patients to report to the emergency department with abdominal pain and affects about 20-40% of the population during life. It is a public health problem and a diagnostic and therapeutic challenge for emergency medicine. 2. OBJECTIVE Show the frequency of acute coronary events, determine the demographic characteristics and risk factors of the subjects, analyze the circumstances of the pain and determine the outcome of treatment and the final diagnosis at discharge / hospitalization. 3. METHODS The study was conducted using data collected from the hospital's information system. The study included subjects who reported to the Unified Emergency Hospital, Zabok general hospital and croatian veterans' hospital, between 01.06.2020 and 01.04.2021. The statistical program R (version 4.0.2) was used for statistical analysis. 4. RESULTS The incidence of acute coronary syndrome was 13,77%. The majority of respondents with ACS are men older than 60 years, while in other respondents both sexes are equally represented. As many as 82,6% of all subjects with chest pain did not visit their chosen physician before coming to Unified emergency hospital admission, and most patients with acute coronary syndrome used TIM1 emergency medical services as their chosen mode of arrival. Triage category 2 is most often assigned to patients with coronary events, and in others, triage category 3 is more often assigned. Hypertension and smoking are represented in both study groups with a higher frequency, compared to other examined factors. Patients with acute coronary syndrome most often report the occurrence of chest pain during rest, and other subjects in equal proportions when performing daily activities and rest. 39,62% of subjects with coronary syndrome report pain in the arm as the most common associated symptom, and patients who have not developed ACS report difficulty breathing. Of all respondents, 75,58% were discharged home and 2 died at OHBP. The final most common diagnoses are ACS, thoracic syndrome, unregulated blood pressure, nonspecific chest pain, and gastritis. 5. CONCLUSION Subjects in the study were patients with chest pain. There are more men than women. The incidence of acute coronay syndome is 13,77%. The most common risk factors that subjects suffer from are hypertension and smoking. Associated symptoms include pain in the arm, shortness of breath, abdominal pain, and rapid heartbeat. Most respondents are discharged home after processing. The diagnosis most often made in the emergency department is non-specific chest pain, in as many as 30,65% of respondents