Contemporary issues in triage and inhospital assessment and management of women’s acute coronary syndrome in Victorian public hospitals: A retrospective study

Coronary heart disease (CHD) is the world’s leading killer of men and women. Mortality rates have improved over recent decades, however reductions in women’s deaths have failed to keep pace with men’s. Heart attack (acute myocardial infarction, AMI) fits within a continuum of CHD known as acute coronary syndrome (ACS). Under-assessment and undertreatment of women’s AMI compared to men’s have been blamed for some of the disparity. Death and disability due to AMI is preventable with timely access to reperfusion therapy, making it one of the most critical conditions managed in the emergency department (ED) and inhospital systems. There is a paucity of literature available specific to women’s ED and inhospital care of ACS and AMI, particularly in Australia, however international research reveals women sometimes fail to receive equitable access to evidence based care compared to their male counterparts, potentially compromising health outcomes. The overall aims of this research were to examine and describe ED triage score allocation and treatment onset patterns in relation to patient sex and other demographic factors, in addition to inhospital access to reperfusion treatment and mortality for women with ACS and AMI in Victorian public hospitals.