Effect of Implementation of HEART Chest Pain Protocol on Emergency Department Disposition, Testing and Cost
| Autor: | Micah J Gaspary, William E. Bylund, Peter M Cole, Michael L Lloyd, Amanda K Osit, Anastasia A Mercer, Sarah W Hussain, Matthew Lawrence |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Chest Pain Emergency Medical Services medicine.medical_specialty Stress testing MEDLINE Cardiology lcsh:Medicine Chest pain Diagnosis Differential Clinical Protocols medicine Humans Acute Coronary Syndrome Retrospective Studies Original Research biology business.industry lcsh:R lcsh:Medical emergencies. Critical care. Intensive care. First aid Retrospective cohort study lcsh:RC86-88.9 General Medicine Emergency department Odds ratio Middle Aged Quality Improvement Troponin Hospitalization Cohort Emergency medicine Emergency Medicine biology.protein Female medicine.symptom Emergency Service Hospital business |
| Zdroj: | Western Journal of Emergency Medicine Western Journal of Emergency Medicine, Vol 22, Iss 2 (2020) |
| ISSN: | 1936-9018 1936-900X |
| Popis: | Background: Symptoms concerning for acute coronary syndromes (ACS) such as chest pain and dyspnea are some of the most common reasons for presenting to an emergency department (ED). The HEART score (history, electrocardiogram, age, risk factors and troponin) was developed and has been externally validated in an emergency setting to determine which patients with chest pain are at increased risk for poor outcomes. Our hospital adopted a HEART score-based protocol in late 2015 to facilitate the management and disposition of these patients. In this study we aimed to analyze the effects of the adoption of this protocol. Prior studies have included only patients with chest pain. We included both patients with chest pain and patients with only atypical symptoms. Methods: This was a retrospective chart review of two cohorts. We identified ED charts from six-month periods prior to and after adoption of our HEART score-based protocol. Patients in whom an electrocardiogram and troponin were ordered were eligible for inclusion. We analyzed data for patients with typical symptoms (chest pain) and atypical symptoms both together and separately. Results: We identified 1546 charts in the pre-adoption cohort and 1623 in the post-adoption cohort that met criteria. We analyzed the first 900 charts in each group. Discharges from the ED increased (odds ratio [OR[1.56, P |
| Databáze: | OpenAIRE |
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