Outcome at 30 days for low-risk chest pain patients assessed using an accelerated diagnostic pathway in the emergency department. Meek, R., Braitberg, G., Cullen, L., Than, M., Graudins, A., & Glynn, D. Emergency Medicine Australasia, 28(3):279–286, June, 2016. ![Outcome at 30 days for low-risk chest pain patients assessed using an accelerated diagnostic pathway in the emergency department [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Objectives Primary: to determine incidence of 30 day major adverse cardiac events (MACE) in patients discharged from the ED following assessment using an accelerated diagnostic pathway (ADP). Secondary: to determine incidence of 30 day MACE for all ADP patients. Methods Monash Health ED patients thought at low risk for acute myocardial infarction (AMI) or hospital admission are assessed using an ADP, based on arrival and 90 min point-of-care (POC) cardiac troponin I and myoglobin concentration. Other patients are assessed using a traditional pathway of arrival and 6 h central lab cardiac troponin I. Choice of pathway is based on the clinical judgement of the attending ED doctor. To investigate the safety of the ADP component, an observational study of all ADP patients presenting from 6 June 2013 to 30 September 2013 was conducted. After 30 days, occurrence of MACE was determined by examination of hospital records or telephone contact with patients who had not returned. Results Of 1547 eligible patients, 1384 (89.5%) were followed up. Of the 1143 discharged patients with follow-up information, 30 day MACE occurred in one (0.09%, 95% CI 0.002–0.5). Of all 1547 patients, 60 patients had a MACE detected: 56 AMI during the initial attendance, four AMI post-discharge (one from ED, three after hospital admission). In total, of the 1328 patients who did not have AMI during the target admission and were followed up, 30 day post-discharge MACE occurred in four patients (0.3%, 95% CI 0.08–0.8). Conclusion The ADP supports safe, early discharge of low-risk chest pain patients from the ED.
@article{meek_outcome_2016,
title = {Outcome at 30 days for low-risk chest pain patients assessed using an accelerated diagnostic pathway in the emergency department},
volume = {28},
issn = {1742-6723},
url = {http://onlinelibrary.wiley.com.ezproxy.otago.ac.nz/doi/10.1111/1742-6723.12570/abstract},
doi = {10.1111/1742-6723.12570},
abstract = {Objectives
Primary: to determine incidence of 30 day major adverse cardiac events (MACE) in patients discharged from the ED following assessment using an accelerated diagnostic pathway (ADP). Secondary: to determine incidence of 30 day MACE for all ADP patients.
Methods
Monash Health ED patients thought at low risk for acute myocardial infarction (AMI) or hospital admission are assessed using an ADP, based on arrival and 90 min point-of-care (POC) cardiac troponin I and myoglobin concentration. Other patients are assessed using a traditional pathway of arrival and 6 h central lab cardiac troponin I. Choice of pathway is based on the clinical judgement of the attending ED doctor. To investigate the safety of the ADP component, an observational study of all ADP patients presenting from 6 June 2013 to 30 September 2013 was conducted. After 30 days, occurrence of MACE was determined by examination of hospital records or telephone contact with patients who had not returned.
Results
Of 1547 eligible patients, 1384 (89.5\%) were followed up. Of the 1143 discharged patients with follow-up information, 30 day MACE occurred in one (0.09\%, 95\% CI 0.002–0.5). Of all 1547 patients, 60 patients had a MACE detected: 56 AMI during the initial attendance, four AMI post-discharge (one from ED, three after hospital admission). In total, of the 1328 patients who did not have AMI during the target admission and were followed up, 30 day post-discharge MACE occurred in four patients (0.3\%, 95\% CI 0.08–0.8).
Conclusion
The ADP supports safe, early discharge of low-risk chest pain patients from the ED.},
language = {en},
number = {3},
urldate = {2018-03-17TZ},
journal = {Emergency Medicine Australasia},
author = {Meek, Robert and Braitberg, George and Cullen, Louise and Than, Martin and Graudins, Andis and Glynn, Deirdre},
month = jun,
year = {2016},
keywords = {\_tablet, acute coronary syndrome, chest pain, emergency department, practice guideline, treatment outcome},
pages = {279--286}
}
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Secondary: to determine incidence of 30 day MACE for all ADP patients. Methods Monash Health ED patients thought at low risk for acute myocardial infarction (AMI) or hospital admission are assessed using an ADP, based on arrival and 90 min point-of-care (POC) cardiac troponin I and myoglobin concentration. Other patients are assessed using a traditional pathway of arrival and 6 h central lab cardiac troponin I. Choice of pathway is based on the clinical judgement of the attending ED doctor. To investigate the safety of the ADP component, an observational study of all ADP patients presenting from 6 June 2013 to 30 September 2013 was conducted. After 30 days, occurrence of MACE was determined by examination of hospital records or telephone contact with patients who had not returned. Results Of 1547 eligible patients, 1384 (89.5%) were followed up. Of the 1143 discharged patients with follow-up information, 30 day MACE occurred in one (0.09%, 95% CI 0.002–0.5). Of all 1547 patients, 60 patients had a MACE detected: 56 AMI during the initial attendance, four AMI post-discharge (one from ED, three after hospital admission). In total, of the 1328 patients who did not have AMI during the target admission and were followed up, 30 day post-discharge MACE occurred in four patients (0.3%, 95% CI 0.08–0.8). Conclusion The ADP supports safe, early discharge of low-risk chest pain patients from the ED.","language":"en","number":"3","urldate":"2018-03-17TZ","journal":"Emergency Medicine Australasia","author":[{"propositions":[],"lastnames":["Meek"],"firstnames":["Robert"],"suffixes":[]},{"propositions":[],"lastnames":["Braitberg"],"firstnames":["George"],"suffixes":[]},{"propositions":[],"lastnames":["Cullen"],"firstnames":["Louise"],"suffixes":[]},{"propositions":[],"lastnames":["Than"],"firstnames":["Martin"],"suffixes":[]},{"propositions":[],"lastnames":["Graudins"],"firstnames":["Andis"],"suffixes":[]},{"propositions":[],"lastnames":["Glynn"],"firstnames":["Deirdre"],"suffixes":[]}],"month":"June","year":"2016","keywords":"_tablet, acute coronary syndrome, chest pain, emergency department, practice guideline, treatment outcome","pages":"279–286","bibtex":"@article{meek_outcome_2016,\n\ttitle = {Outcome at 30 days for low-risk chest pain patients assessed using an accelerated diagnostic pathway in the emergency department},\n\tvolume = {28},\n\tissn = {1742-6723},\n\turl = {http://onlinelibrary.wiley.com.ezproxy.otago.ac.nz/doi/10.1111/1742-6723.12570/abstract},\n\tdoi = {10.1111/1742-6723.12570},\n\tabstract = {Objectives\n\nPrimary: to determine incidence of 30 day major adverse cardiac events (MACE) in patients discharged from the ED following assessment using an accelerated diagnostic pathway (ADP). Secondary: to determine incidence of 30 day MACE for all ADP patients.\n\n\nMethods\n\nMonash Health ED patients thought at low risk for acute myocardial infarction (AMI) or hospital admission are assessed using an ADP, based on arrival and 90 min point-of-care (POC) cardiac troponin I and myoglobin concentration. Other patients are assessed using a traditional pathway of arrival and 6 h central lab cardiac troponin I. Choice of pathway is based on the clinical judgement of the attending ED doctor. To investigate the safety of the ADP component, an observational study of all ADP patients presenting from 6 June 2013 to 30 September 2013 was conducted. After 30 days, occurrence of MACE was determined by examination of hospital records or telephone contact with patients who had not returned.\n\n\nResults\n\nOf 1547 eligible patients, 1384 (89.5\\%) were followed up. Of the 1143 discharged patients with follow-up information, 30 day MACE occurred in one (0.09\\%, 95\\% CI 0.002–0.5). Of all 1547 patients, 60 patients had a MACE detected: 56 AMI during the initial attendance, four AMI post-discharge (one from ED, three after hospital admission). In total, of the 1328 patients who did not have AMI during the target admission and were followed up, 30 day post-discharge MACE occurred in four patients (0.3\\%, 95\\% CI 0.08–0.8).\n\n\nConclusion\n\nThe ADP supports safe, early discharge of low-risk chest pain patients from the ED.},\n\tlanguage = {en},\n\tnumber = {3},\n\turldate = {2018-03-17TZ},\n\tjournal = {Emergency Medicine Australasia},\n\tauthor = {Meek, Robert and Braitberg, George and Cullen, Louise and Than, Martin and Graudins, Andis and Glynn, Deirdre},\n\tmonth = jun,\n\tyear = {2016},\n\tkeywords = {\\_tablet, acute coronary syndrome, chest pain, emergency department, practice guideline, treatment outcome},\n\tpages = {279--286}\n}\n\n","author_short":["Meek, R.","Braitberg, G.","Cullen, L.","Than, M.","Graudins, A.","Glynn, D."],"key":"meek_outcome_2016","id":"meek_outcome_2016","bibbaseid":"meek-braitberg-cullen-than-graudins-glynn-outcomeat30daysforlowriskchestpainpatientsassessedusinganaccelerateddiagnosticpathwayintheemergencydepartment-2016","role":"author","urls":{"Paper":"http://onlinelibrary.wiley.com.ezproxy.otago.ac.nz/doi/10.1111/1742-6723.12570/abstract"},"keyword":["_tablet","acute coronary syndrome","chest pain","emergency department","practice guideline","treatment outcome"],"downloads":0},"search_terms":["outcome","days","low","risk","chest","pain","patients","assessed","using","accelerated","diagnostic","pathway","emergency","department","meek","braitberg","cullen","than","graudins","glynn"],"keywords":["_tablet","acute coronary syndrome","chest pain","emergency department","practice guideline","treatment outcome"],"authorIDs":[],"dataSources":["ehmLBKMxLmAEHFGjZ"]}