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ED chest pain units and physician discretion may lower stress test use
Date:3/26/2012

ps have recommended very liberal use of stress testing and evaluation by a cardiologist is often reserved for those patients with positive stress tests only. As a result, the lower rates of missed AMI and unstable angina are likely the result of liberal use of stress testing.

With this in mind, Napoli and his colleagues conducted an observational study within the Rhode Island Hospital emergency department, a Level I trauma center with a chest pain unit (CPU). Their goal was to determine whether selective use of stress testing in a CPU managed jointly by emergency physicians and cardiologists was associated with a low incidence of 30-day major adverse cardiac events while maintaining a low stress test utilization rate.

During an eight-month period, 1,063 patients were included in the study. Napoli says, "To our knowledge, this is one of the largest single center observational trials of 30-day adverse events of CPU patients to date. We found only 51 percent of the patients received a stress test, with very few adverse events."

Napoli adds, "We believe that patients who are seen for chest pain may benefit from the protocol that is used in the Rhode Island Hospital CPU, and this may lower the cost of care through more selective stress test utilization."


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Contact: Nancy Jean
njean@lifespan.org
Lifespan
Source:Eurekalert  

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