What question did this study set out to answer?

This research aims to examine chest pain presentations and outcomes in emergency departments, focusing on sex-based differences.

February 22, 2026Emergency Medicine Australasia0 citationsOpen Access

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

JSJonathon Stewart JLJuan Lu AGAdrian Goudie

Key Result

Females presenting with chest pain were triaged less urgently yet had lower 30-day ACS and death rates; discharged patients had a low risk (0.4% ACS, 0.1% death) within 30 days.

Key Points

This research aims to examine chest pain presentations and outcomes in emergency departments, focusing on sex-based differences.
Conducted a retrospective cohort study using linked data from the Western Australian Data Linkage System.
Included adults presenting with non-traumatic chest pain from January 2016 to October 2020.
Identified comorbidities through 10 years of morbidity data.
Primary outcome assessed was diagnosis of acute coronary syndrome or all-cause death within 30 days of ED discharge.
Included 64,404 patients with a mean age of 54.8 years, 49.2% female.
Females received a lower triage category compared to males, showing disparities in urgency.
0.4% of patients diagnosed with acute coronary syndrome and 0.1% died within 30 days of discharge.
No significant differences in triage scores between sexes when focusing on those with 30-day outcomes.

Structured PICO

Population

64,404 adults presenting with non-traumatic chest pain to emergency departments in Western Australia between January 2016 and October 2020, mean age 54.8 years, 49.2% female.

Outcome

Composite of diagnosis of acute coronary syndrome (ACS) or all-cause death within 30 days of ED dischargecomposite

Patients discharged home from the ED with non-traumatic chest pain have a very low 30-day risk of ACS or death, and while females are triaged less urgently, they have lower adverse event rates than males.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

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

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