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Titolo:
Safe discharge from the cardiac emergency room with a rapid rule-out myocardial infarction protocol using serial CK-MBmass
Autore:
Bholasingh, R; de Winter, RJ; Fischer, JC; Koster, RW; Peters, RJG; Sanders, GT;
Indirizzi:
Acad Med Ctr, Dept Cardiol, NL-1105 AZ Amsterdam, Netherlands Acad Med Ctr Amsterdam Netherlands NL-1105 AZ AZ Amsterdam, Netherlands
Titolo Testata:
HEART
fascicolo: 2, volume: 85, anno: 2001,
pagine: 143 - 148
SICI:
1355-6037(200102)85:2<143:SDFTCE>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE CHEST PAIN; CREATINE KINASE-MB; PROGRAM WORKING GROUP; TROPONIN-T; LOW-RISK; ISCHEMIA; DIAGNOSIS; MASS; STRATEGY; TECHNOLOGIES;
Keywords:
length of stay; cardiac emergency room; creatine kinase-MB; myocardial infarction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Bholasingh, R Acad Med Ctr, Dept Cardiol, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands Acad Med Ctr Meibergdreef 9 Amsterdam Netherlands NL-1105 AZ
Citazione:
R. Bholasingh et al., "Safe discharge from the cardiac emergency room with a rapid rule-out myocardial infarction protocol using serial CK-MBmass", HEART, 85(2), 2001, pp. 143-148

Abstract

Objective-To determine whether a new protocol, using a rapid and sensitiveCK-MBmass assay and serial sampling, can rule out myocardial infarction inpatients with chest pain and decrease their length of stay in the cardiac emergency room without increasing risk. Design-The combined incidence of cardiac death and acute myocardial infarction at 30 days, six months, and 24 months of follow up were compared between patients discharged home from the cardiac emergency room after ruling out myocardial infarction with a CK-MBactivity assay in 1994 and those discharged home after a rapid CK-MBmass assay in 1996. Setting-Cardiac emergency room of a large university hospital. Patients-In 1994 and 1996, 230 and 423 chest pain patients, respectively, were discharged home from the cardiac emergency room with a normal CK-MB and an uneventful observation period. Results-The median length of stay in the cardiac emergency room was significantly reduced, from 16.0 hours in 1994 to 9.0 hours in 1996 (p < 0.0001). Mean event rates in patients from the 1994 and 1996 cohorts, respectively,were 0.9% (95% confidence interval (CI) -0.3% to 2.1%) <nu> 0.7% (95% CI -0.1% to 1.5%) at 30 days, 3.0% (95% CI 0.8% to 5.2%) nu 2.8% (95% CI 1.2% to 4.4%) at six months, and 7.0% (95% CI 3.7% to 10.3%) nu 5.7% (95% CI 3.5%to 7.9%) at 24 months. Kaplan-Meier survival analysis showed no differencein mean event-free survival at 30 days, six months, and 24 months of follow up. Conclusions-Using a rule-out myocardial infarction protocol with a rapid and sensitive CK-MBmass assay and serial sampling, the length of stay of patients with chest pain in the cardiac emergency room can be reduced without compromising safety.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 10:53:55