Article Text

Download PDFPDF
National trends in chest pain visits in US emergency departments (2006–2016)
  1. Ahmad A Aalam1,2,
  2. Awad Alsabban3,4,
  3. Jesse M Pines5
  1. 1 Department of Emergency Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
  2. 2 Department of Emergency Medicine, George Washington University, Washington, District of Columbia, USA
  3. 3 Department of Internal Medicine, Taif University College of Medicine, Taif, Saudi Arabia
  4. 4 Department of Internal Medicine, George Washington University, Washington, District of Columbia, USA
  5. 5 US Acute Care Solutions, Canton, Ohio, USA
  1. Correspondence to Dr Ahmad A Aalam, Emergency Medicine, King Abdulaziz University Faculty of Medicine, Jeddah 21441, Saudi Arabia; dr.aalam{at}


Background Chest pain is a common complaint in EDs. In this study, we describe demographic, care and cost trends in US ED visits for chest pain over 11 years.

Methods This is a retrospective descriptive study of trends in utilisation and care of ED chest pain visits from 2006 to 2016) using data from the Healthcare Cost and Utilization Project database, a national sample of US ED visits and hospitalisations.

Results From 2006 to 2016, there were 42.48 million chest pain visits. Visits per 100 000 persons increased from 1140.4 in 2006 to 1611.7 in 2016 (p<0.001). The chest pain inpatient admission rate declined from 19% in 2006 to 3.9% in 2016 (p<0.001); associated inpatient hospitalisation costs declined from $10.4 billion (2006–2008) to $6.2 billion (2012–2014).

Conclusion From 2006 to 2016, ED visits in the USA for chest pain increased with a significant decline in admission rates and inpatient hospitalisation costs.

  • admission avoidance
  • emergency care systems
  • admission avoidance
  • chest
  • cardiac care
  • acute coronary syndrome
  • emergency department utilisation

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Handling editor Edward Carlton

  • Twitter @draalam

  • Contributors AAA and JMP planned the study. AAA and AA collected data and analysed it. All authors wrote and edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval This study was exempted by The George Washington University Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available online as part of The Healthcare Cost and Utilization Project at ( by The Agency for Healthcare Research and Quality's.