Re-admissions among patients with acute chest pain who were discharged from the emergency department.

This paper describes the rate of re-admission and the characteristics of patients who were re-admitted after having been discharged directly from the emergency department at Sahlgrenska Hospital when they presented with acute chest pain or other symptoms suggestive of acute myocardial infarction. A total of 1463 patients were admitted and directly discharged during the 15 month recruitment period, of whom 222 (15%) were re-admitted at least once and 72 (5%) were re-admitted more than once during the subsequent 6 to 21 months. However, among patients not being re-admitted, 63% reported recurrency of symptoms one year after discharge. Re-admitted patients differed from those who were not re-admitted by: being older (p < 0.001); they more frequently had a history of cardiovascular diseases (p < 0.001); they more frequently had a pathological electrocardiogram (p < 0.001); and they were more frequently judged to have angina pectoris (p < 0.001). Among re-admitted patients, about half were hospitalized but only 10% developed AMI. In conclusion, among patients who were discharged directly from the emergency department with acute chest pain, 15% were re-admitted with similar symptoms only. A minority, however, developed acute myocardial infarction. A high proportion of patients not being re-admitted had recurrency of symptoms.