Heartburn or angina? Differentiating gastrointestinal disease in primary care patients presenting with chest pain: a cross sectional diagnostic study

Table 2 Clinical characteristics associated with GI disease (including GERD) and with GERD (multivariable model, n = 1212)

Index test	Unadjusted OR (95%-CI)	adjusted OR (95%-CI)	p value
Association with GI disease
Burning pain	3.30 (1.92-5.67)	3.16 (1.53-6.49)	<0.01
Vomiting,	5.59 (3.14-9.97)	8.01 (3.80-16.85)	<0.01
Pain worse with food intake	18.83 (8.86-40.02)	31.27 (8.82-110.82)	<0.01
Retrosternal pain localisation	1.95 (1.15-3.32)	2.37 (1.10-5.10)	0.03
Epigastric pain localisation	2.48 (1.45-4.25)	3.48 (1.63-7.46)	<0.01
Retrosternal pain radiation	6.68 (3.51-12.72)	5.02 (1.90-13.25)	<0.01
Average pain episode < 1 hour	2.34 (1.36-4.02)	3.30 (1.57-6.91)	<0.01
Pain worse with movement,	0.22 (0.10-0.52)	0.36 (0.14-0.94)	0.04
Pain depending on exercise	0.21 (0.08-0.57)	0.15 (0.04-0.58)	<0.01
Localised muscle tension	0.45 (0.26-0.80)	0.44 (0.22-0.90)	0.03
Pain worse with breathing	0.21 (0.07-0.57)	0.33 (0.11-0.99)	0.05
Pain on the left side	0.25 (0.15-0.42)	0.42 (0.22-0.81)	0.01

Association with GERD
Pain worse with food intake	14.23 (6.09-33.27)	16.49 (4.39-61.99)	<0.01
Retrosternal pain localisation	3.83 (1.69-8.71)	3.18 (0.98-10.32)	0.05
Retrosternal pain radiation	8.29 (3.93-17.49)	6.32 (2.21-18.06)	<0.01
Pain on the left side	0.19 (0.10-0.39)	0.40 (0.14-1.11)	0.08
Localised muscle tension	0.25 (0.10-0.61)	0.35 (0.13-0.94)	0.04

For GI disease the following variables were selected for multivariable analysis (according to performance markers in univariate analysis: p < 0.05; OR >2 or <0.5): burning pain, vomiting, pain worse with ingestion, retrosternal pain localisation, epigastric pain localisation, pain on the left side, retrosternal pain radiation, average pain episode < 1 hour, average pain episode < 1 minute, pain worse with movement, pain depending on exercise, stinging pain, localized muscle tension, patient dyspnoeic, pain worse with breathing.
For GERD the following variables were selected for multivariable analysis (according to performance markers in univariate analysis: p < 0.05; OR >2 or <0.5): burning pain, vomiting, pain worse with ingestion, retrosternal pain localisation, pain on the left side, retrosternal pain radiation, continuous pain, average pain episode < 1 hour, pain worse with movement, pain depending on exercise, stinging pain, localized muscle tension, pain worse with breathing, pain at the time of consultation, pain reproduced by palpation.