Investigation of the factors affecting the behavior of emergency medicine physicians regarding the giving of acetylsalicylic acid in patients admitting with chest pain

This study aimed to evaluate physician- or patient-based factors influencing physicians\' decisions to administer acetylsalicylic acid (ASA) in the early management of patients presenting to the emergency department with chest pain. Designed as a cross-sectional survey study, this research was conducted across Türkiye between November 26, 2020, and July 13, 2021. The study included 351 emergency medicine specialists and 39 general practitioners actively working in emergency departments. Participants were administered a questionnaire consisting of 6 demographic and 36 case-based questions. The study found that ASA was administered at a higher rate to male patients compared to female patients. In male patients with typical chest pain, the rate of ASA administration was 95.8%, while in female patients, it was 16.6% (p<0.001). In male patients with atypical chest pain, the rate of ASA administration was 67.4%, compared to 6.1% in female patients (p=0.003). Physician gender and experience also influenced ASA administration decisions. Male physicians administered ASA 3.2 times more frequently to male patients with atypical chest pain compared to female physicians (OR: 3.2; 95% CI: 1.8-5.6). Additionally, physicians with more than 10 years of experience increased ASA use in patients with comorbidities by 1.8 times (p=0.02). This study is one of the first in Türkiye to examine emergency physicians\' ASA administration practices. The findings indicate that physicians tend to administer ASA less frequently to female patients compared to male patients. However, as physicians gain experience and advance in their specialization, their adherence to guideline-based treatment increases. These results highlight the importance of specialization and continuous medical education in medical training.