Presenting characteristics and processing times for culturally and linguistically diverse (CALD) patients with chest pain in an emergency department: Time, Ethnicity and Delay (TED) Study II

Background: There is limited information about characteristics and timeliness of management in an Emergency Department (ED) for culturally and linguistically diverse (CALD) patients with chest pain. The aim of this study was to describe the presenting characteristics and process times in ED for CALD patients with chest pain and compare to the Australian-born population, and compare these outcomes with the recommendations from current guidelines Methods: This study was a cross sectional analysis of a cohort of all patients who presented with chest pain to metropolitan tertiary referral service between 1 July 2012 and 30 June 2014 were included. Results: Of the 6,640 patients who presented, 1,241(18.7%) were identified as CALD and 5,399 (81.3%) were Australian-born. CALD patients were significantly older than Australian-born patients (mean age 62 vs 56 years, p<0.001). There were no differences in central chest pain presentation (74.9% vs 75.7%, p =0.526); ambulance utilisation (41.7% vs 41.1%, p= 0.697); waiting time to initial treatment in ED (21 vs 22 minutes, p=0.375); and waiting time for admission to hospital after ED care (3.2 vs 3.3 hours, p=0.051). CALD patients were 22% less likely to receive the guideline management for chest pain; however, there was no difference in guideline adherence between two groups with equally low rates of 12.5% vs 13%, p=0.556. Conclusions: There was no significant difference in emergency care provision between both groups. We hypothesise that cultural awareness was being practiced well in this centre in the context of low levels of guideline adherence for all patients with chest pain.