{"id":10434,"date":"2017-12-20T00:00:00","date_gmt":"2017-12-20T00:00:00","guid":{"rendered":"http:\/\/research.christianacare.org\/publications\/2017\/12\/20\/immediate-stress-echocardiography-for-low-risk-chest-pain-patients-in-the-emergency-department-a-prospective-observational-cohort-study\/"},"modified":"2021-12-13T21:13:55","modified_gmt":"2021-12-13T21:13:55","slug":"immediate-stress-echocardiography-for-low-risk-chest-pain-patients-in-the-emergency-department-a-prospective-observational-cohort-study","status":"publish","type":"post","link":"https:\/\/research.christianacare.org\/publications\/2017\/12\/20\/immediate-stress-echocardiography-for-low-risk-chest-pain-patients-in-the-emergency-department-a-prospective-observational-cohort-study\/","title":{"rendered":"Immediate Stress Echocardiography for Low-Risk Chest Pain Patients in the Emergency Department: A Prospective Observational Cohort Study"},"content":{"rendered":"<p>Jasani G, Papas M, Patel AJ, Jasani N, Levine B, Zhang Y, Marshall ES<\/p>\n<p>J Emerg Med 2018 Feb;54(2):156-164<\/p>\n<p>PMID: <a href='https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29274930' title=''>29274930<\/a><\/a><\/p>\n<h2>Abstract<\/h2>\n<p><p><strong>BACKGROUND: <\/strong>Evaluation and disposition of low-risk chest pain (CP) patients in the emergency department (ED) is time consuming and expensive. Low-risk CP often results in hospital admission to rule out myocardial infarction, which leads to additional costs and delays.<\/p>\n<p><strong>OBJECTIVE: <\/strong>Our aim was to assess whether an immediate exercise stress echocardiogram (IESE) in the ED will allow safe, efficient, and cost-effective evaluation and discharge of patients with low-risk CP.<\/p>\n<p><strong>METHODS: <\/strong>Low-risk CP patients (TIMI [Thrombolysis in Myocardial Infarction] score 0-1) presenting to the ED with normal electrocardiogram, no history of coronary artery disease, and negative troponin T received IESE. We followed these patients for major adverse cardiac events and compared them to a control cohort of similar-risk patients admitted with traditional care at 1 and 6\u00a0months.<\/p>\n<p><strong>RESULTS: <\/strong>We enrolled 216 patients, 117 IESE and 109 control. We obtained follow-up at 1 and 6\u00a0months in 94% of the IESE group and 88% in the control group. There was no difference in diagnostic catheterization or percutaneous coronary intervention between the 2 groups (6.0% and 1.7% vs. 6.4% and 1.8%; p\u00a0=\u00a00.89). Median time from triage to discharge was significantly shorter with IESE (572.6\u00a0min vs. 1466.0\u00a0min), resulting in significantly lower cost ($4380.50 vs. $6191.70). There were no adverse events related to IESE or early discharge.<\/p>\n<p><strong>CONCLUSIONS: <\/strong>In our study, IESE for low-risk CP patients presenting to the ED has the potential to be equally safe, more expeditious, and more\u00a0cost effective than admission to an observation unit.<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Jasani G, Papas M, Patel AJ, Jasani N, Levine B, Zhang Y, Marshall ES J Emerg Med 2018 Feb;54(2):156-164 PMID: 29274930 Abstract BACKGROUND: Evaluation and disposition of low-risk chest pain (CP) patients in the emergency department (ED) is time consuming and expensive. Low-risk CP often results in hospital admission to rule out myocardial infarction, which<\/p>\n<p><a class=\"more-link\" href=\"https:\/\/research.christianacare.org\/publications\/2017\/12\/20\/immediate-stress-echocardiography-for-low-risk-chest-pain-patients-in-the-emergency-department-a-prospective-observational-cohort-study\/\">Continue reading <span class=\"screen-reader-text\">Immediate Stress Echocardiography for Low-Risk Chest Pain Patients in the Emergency Department: A Prospective Observational Cohort Study<\/span><\/a><\/p>\n","protected":false},"author":61,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[41,1],"tags":[],"class_list":["post-10434","post","type-post","status-publish","format-standard","hentry","category-ireach","category-pubs-pres"],"acf":[],"_links":{"self":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/posts\/10434","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/comments?post=10434"}],"version-history":[{"count":0,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/posts\/10434\/revisions"}],"wp:attachment":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/media?parent=10434"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/categories?post=10434"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/tags?post=10434"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}