The triple work-up for emergency department patients with acute chest pain

• Verfasst von: Rogg, Jonathan G. [VerfasserIn]
• Verfasst von: De Neve, Jan-Walter [VerfasserIn]
• Verfasst von: Huang, Calvin [VerfasserIn]
• Verfasst von: Brown, David [VerfasserIn]
• Verfasst von: Jang, Ik-Kyung [VerfasserIn]
• Verfasst von: Chang, Yuchiao [VerfasserIn]
• Verfasst von: Marill, Keith [VerfasserIn]
• Verfasst von: Parry, Blair [VerfasserIn]
• Verfasst von: Hoffmann, Udo [VerfasserIn]
• Verfasst von: Nagurney, John T. [VerfasserIn]
• Titel: The triple work-up for emergency department patients with acute chest pain
• Titelzusatz: how often does it occur?
• Verf.angabe: Jonathan G. Rogg, SB, Jan-Walter De Neve, BS, Calvin Huang, MD, David Brown, MD, Ik-Kyung Jang, MD, PHD, Yuchiao Chang, PHD, Keith Marill, MD, Blair Parry, BA, Udo Hoffmann, MD, MPH, John T. Nagurney, MD, MPH
• E-Jahr: 2011
• Jahr: 2008
• Umfang: 7 S.
• Fussnoten: Available online 14 September 2008 ; Gesehen am 17.12.2020
• Titel Quelle: Enthalten in: The journal of emergency medicine
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1983
• Jahr Quelle: 2011
• Band/Heft Quelle: 40(2011), 2, Seite 128-134
• ISSN Quelle: 0736-4679
• DOI: doi:10.1016/j.jemermed.2008.02.031
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: acute coronary syndrome
• Sach-SW: aortic dissection
• Sach-SW: chest pain
• Sach-SW: pulmonary embolus
• K10plus-PPN: 174313634X

Abstract

Objectives: To measure the degree of overlap and diagnostic yield for evaluations of acute coronary syndrome (ACS), pulmonary embolism (PE), and aortic dissection (AD) among Emergency Department (ED) patients. Methods: We conducted a cross-sectional descriptive study of consecutive adult patients seen in the ED of a 78,000-annual-visit urban academic medical center. Patients who had received at least one of eight of the tests used in our ED to diagnose these three diseases were identified through three methods, and a final study population list was created. Overlap of evaluations and diagnostic yields were calculated by simple descriptive statistics. Results: Over a 2-week period, 626 patient encounters among 622 unique patients were identified. Among these 626 visits, 139 (22%) included diagnostic tests for more than one of the three diagnoses of interest. The majority of these multiple tests were for ACS plus PE (n = 121, 87% of all multiple tests), whereas a minority of patients received tests for ACS plus AD (n = 14, 10% of all multiple tests) or for the “triple work-up” of ACS plus PE plus AD (n = 4, 2.9% of all multiple tests). Conclusion: Although the “triple work-up” evaluation for ACS, PE, and AD is relatively uncommon, a significant number of ED patients who are evaluated for at least one of these three major chest pain syndromes receive simultaneous testing for one of the others.