Weekend and holiday exercise testing in patients with chest pain.
OBJECTIVE
To determine the outcome, safety, and possible cost savings of patients undergoing weekend or holiday exercise treadmill testing.


METHODS
Medical records of all 195 patients scheduled for weekend and holiday exercise testing were reviewed, and 77.9% of patients were contacted by telephone to ascertain medical outcomes and need for further emergency department or inpatient care. Costs were calculated from estimates of days of hospitalization saved and incremental costs incurred in conjunction with weekend or holiday testing.


METHODS
Urban tertiary care academic medical center.


METHODS
A total of 195 patients were scheduled for testing, and 181 tests were performed. Over three quarters (75.1%) of patients underwent testing for assessment of chest pain. Other indications included risk stratification after myocardial infarction or coronary angioplasty or prior to noncardiac surgery, or evaluation for arrhythmias, dyspnea, or syncope.


RESULTS
Outcomes included results and complications of testing, hospital course after testing, subsequent emergency department visits and readmissions, myocardial infarction, need for cardiac catheterization or revascularization, and mortality. No complications were noted during testing. In 136 patients tested for the indication of chest pain, 90 (66.2%) had negative tests, 39 (28. 7%) were intermediate, and 6 (4.4%) were positive for ischemia. Same day discharge occurred in 115 (84.6%) of the patients, saving an estimated 185 days of hospitalization ($316.83 per patient tested). Event rates over the 6 months following discharge were low.


CONCLUSIONS
Weekend and holiday exercise testing is a safe and effective means of risk stratification prior to hospital discharge for patients with chest pain. It also reduces length of stay and is cost saving.
Krasuski
R A
RA
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass, USA.
Hartley
L H
LH
Lee
T H
TH
Polanczyk
C A
CA
Fleischmann
K E
KE
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000209:etiology*; D003362:Cost-Benefit Analysis; D005080:Exercise Test / Q000009:adverse effects / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006693:Holidays; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012307:Risk Factors