{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T19:30:53Z","timestamp":1786476653865,"version":"build-2736575974"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR001420"],"award-info":[{"award-number":["UL1TR001420"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aims to determine if differences in age affect safety and healthcare utilization among patients with chest pain in a multisite US ED cohort, after accounting for comorbidities and high\u2010sensitivity troponin (hs\u2010cTn).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multisite observational study using the Wake Forest Chest Pain Registry, which included patients\u2009\u2265\u200918 years old with chest pain across 25 EDs (01\/01\/2021 to 12\/31\/2021). Each site used an hs\u2010cTn chest pain protocol. Patients were categorized as older (\u2265\u200965 years), middle\u2010aged (46\u221264 years), or young (18\u221245 years). The primary safety outcome was death or MI at 30 days. The primary healthcare utilization outcome was 30\u2010day hospitalization. Multivariable logistic regression models assessed the association between age and outcomes, adjusting for sex, race, ethnicity, obesity, smoking, rurality, coronary disease, diabetes, hypertension, hyperlipidemia, insurance, site, and hs\u2010cTn, with young patients as the reference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 40\u2009979 patients, 25.1% were older, 39.7% middle\u2010aged, and 35.2% young. At 30 days, death or MI occurred in 7.3% (750\/10\u2009298) of older, 3.8% (611\/16\u2009260) of middle\u2010aged, and 0.8% (108\/14\u2009421) of young patients. After adjustment, death or MI at 30 days was more common among older (aOR 1.57, 95% CI 1.17\u22122.12) and middle\u2010aged (aOR 1.57, 95% CI 1.22\u20102.02) patients. Hospitalization at 30 days occurred in 56.3% (5799\/10\u2009298) of older, 35.4% (5761\/16\u2009260) of middle\u2010aged, and 12.8% (1849\/14\u2009421) of young patients. With adjustment, hospitalization remained more common among older (aOR 2.51, 95% CI 2.27\u22122.78) and middle\u2010aged (aOR 1.93, 95% CI 1.80\u22122.07) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After adjusting for comorbidities and hs\u2010cTn results, older adults had higher rates of death or MI and hospitalization at 30 days.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70275","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T14:39:17Z","timestamp":1776782357000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age Differences in Acute Chest Pain Care in a Multisite US Cohort"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3466-8813","authenticated-orcid":false,"given":"Nicklaus 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Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Supples","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin T.","family":"Hutchison","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Pearson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Carolinas Medical Center Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon A.","family":"Mahler","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Wake Forest University School of Medicine 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