Original scientific paper
https://doi.org/10.3325/cmj.2015.56.422
Causes of chest pain in primary care – a systematic review and meta-analysis
Jörg Haasenritter
; Department of General Practice/ Family Medicine, Philipps University of Marburg, Marburg, Germany
Tobias Biroga
; Department of General Practice/ Family Medicine, Philipps University of Marburg, Marburg, Germany
Christian Keunecke
; Department of General Practice/ Family Medicine, Philipps University of Marburg, Marburg, Germany
Annette Becker
; Department of General Practice/ Family Medicine, Philipps University of Marburg, Marburg, Germany
Norbert Donner-Banzhoff
; Department of General Practice/ Family Medicine, Philipps University of Marburg, Marburg, Germany
Katharina Dornieden
; Department of General Practice/ Family Medicine, Philipps University of Marburg, Marburg, Germany
Rebekka Stadje
; Department of General Practice/ Family Medicine, Philipps University of Marburg, Marburg, Germany
Annika Viniol
; Department of General Practice/ Family Medicine, Philipps University of Marburg, Marburg, Germany
Stefan Bösner
; Department of General Practice/ Family Medicine, Philipps University of Marburg, Marburg, Germany
Abstract
Aim To investigate the frequencies of different and relevant
underlying etiologies of chest pain in general practice.
Methods We systematically searched PubMed and EMBASE.
Two reviewers independently rated the eligibility of
publications and assessed the risk of bias of included studies.
We extracted data to calculate the relative frequencies
of different underlying conditions and investigated the
variation across studies using forest plots, I2, tau2, and prediction
intervals. With respect to unexplained heterogeneity,
we provided qualitative syntheses instead of pooled
estimates.
Results We identified 11 eligible studies comprising about
6500 patients. The overall risk of bias was rated as low in
6 studies comprising about 3900 patients. The relative frequencies
of different conditions as the underlying etiologies
of chest pain reported by these studies ranged from
24.5 to 49.8% (chest wall syndrome), 13.8 to 16.1% (cardiovascular
diseases), 6.6 to 11.2% (stable coronary heart disease),
1.5 to 3.6% (acute coronary syndrome/myocardial
infarction), 10.3 to 18.2% (respiratory diseases), 9.5 to 18.2%
(psychogenic etiologies), 5.6 to 9.7% (gastrointestinal disorders),
and 6.0 to 7.1% (esophageal disorders).
Conclusion This information may be of practical value for
general practitioners as it provides the pre-test probabilities
for a range of underlying diseases and may be suitable
to guide the diagnostic process.
Keywords
Hrčak ID:
151733
URI
Publication date:
15.10.2015.
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