English abstract
Objectives: To determine predictors associated with positive
chest x-ray finding in patients presenting with non-traumatic
chest pain in the Emergency Department (ED).
Methods: Health records, including the final radiology reports
of all patients who presented with non-traumatic chest pain and
had a chest x-ray performed in an urban Canadian tertiary care
ED over four consecutive months were reviewed. Demographic
and clinical variables were also extracted. Chest x-ray findings
were categorized as normal (either normal or no significant
change from previous x-rays) or abnormal. Descriptive statistics
were used to describe the data. Multivariable logistic regression
was used to determine the association between various predictors
and chest x-ray finding (positive/negative).
Results: The 330 study patients had the following characteristics:
mean age 58±20 years; female 41% (n=134). Patients' chief
complaints were only chest pain 75% (n=248), chest pain with
shortness of breath 12% (n=41), chest pain with palpitation 4%
(n=14), chest pain with other complaints 9% (n=28). Chest x-rays
were reported as normal or no acute changes in 81% (n=266) of
patients, and abnormal in 19% (n=64) of patients. The most common
abnormal chest x-ray diagnoses were congestive heart failure (n=28;
8%) and pneumonia (n=17; 5%). Those with abnormal chest x-ray
findings were significantly older (71 versus 55 years; p<0.001), had
chest pain with shortness of breath (36% versus 11%; p<0.001), had
significant past medical history (39% versus 14%; p<0.001), and
were also tachypnoic (31% versus 12%; p<0.001).
Conclusion: This study found that patients with non-traumatic
chest pain are likely to have a normal chest x-ray if they were
young, not tachypnoeic or short of breath, and had no significant
past medical history. A larger study is required to confirm these
findings.
