التفاصيل البيبلوغرافية
| العنوان: |
A streamlined Emergency Department approach to moderate risk chest pain in patients with no pre‐existing coronary artery disease: A pilot study. |
| المؤلفون: |
Jones, Christopher L, Gallagher, Robyn, Quinn, Paddy, Lan, Nick S R, Thomas, David‐Raj, Wood, Christopher, Lau, Christopher, Chow, Weng Man Sofia, Raju, Vikram, Rankin, James M, Ihdayhid, Abdul Rahman, Arendts, Glenn |
| المصدر: |
Emergency Medicine Australasia; Jun2024, Vol. 36 Issue 3, p378-388, 11p |
| مصطلحات موضوعية: |
RISK assessment, TROPONIN, CHEST pain, PILOT projects, MAJOR adverse cardiovascular events, HOSPITAL emergency services, LONGITUDINAL method, CORONARY artery disease, LENGTH of stay in hospitals, COMPARATIVE studies, DISEASE risk factors, DISEASE complications |
| مصطلحات جغرافية: |
AUSTRALIA |
| مستخلص: |
Objective: Moderate risk patients with chest pain and no previously diagnosed coronary artery disease (CAD) who present to ED require further risk stratification. We hypothesise that management of these patients by ED physicians can decrease length of stay (LOS), without increasing patient harm. Methods: A prospective pilot study with comparison to a pre‐intervention control group was performed on patients presenting with chest pain to an ED in Perth, Australia between May and October 2021, following the introduction of a streamlined guideline consisting of ED led decision making and early follow up. Patients had no documented CAD and were at moderate risk of major adverse cardiac events (MACE). Electronic data was used for comparison. Primary outcomes were total LOS and LOS following troponin. Results: One hundred eighty‐six patients were included. Median total LOS was reduced by 62 min, but this change was not statistically significant (482 [360–795] vs 420 [360–525] min, P = 0.06). However, a significant 60 min decrease in LOS was found following the final troponin (240 (120–571) vs 180 (135–270) min, P = 0.02). There was no difference in the rate of MACE (0% vs 2%, P = 0.50), with no myocardial infarction or death. Conclusions: Our study suggests that patients with no pre‐existing CAD can be safely managed by emergency physicians streamlining their ED management and decreasing LOS. This pathway could be used in other centres following confirmation of the results by a larger study. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |