Early data suggest new protocol to risk-stratify chest pain patients, potentially preserving resources without compromising safety.
Early data from the study of a new protocol suggest there may be a more efficient way to risk-stratify patients presenting to the ED with chest pain so that lower-risk patients can be safely discharged rather face longer hospital stays and expensive tests. The approach, dubbed the HEART Pathway, involves using the HEART score, a clinical decision tool developed in the Netherlands, along with slight modifications including a second blood test for troponin levels. Experts say that the United States spends $10 to $13 billion per year for workups on chest pain patients when fewer than 10% are actually having an acute coronary syndrome. In a single-center randomized controlled trial, investigators found that when compared to usual care, use of the HEART Pathway resulted in 12% fewer cardiac tests, shorter lengths-of-stay, and 21% more early discharges. No patients in either group experienced a major cardiac complication within 30 days of their ED visit. Larger studies of the HEART Pathway approach are being implemented with more robust findings expected within a year.
D002637:Chest Pain / Q000209:etiology; D002985:Clinical Protocols; D004636:Emergency Service, Hospital / Q000191:economics; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis*; D061214:Patient Safety; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment / Q000379:methods; D014336:Troponin / Q000097:blood
D014336:Troponin