Rapid Assessment Identifies Low-Risk Chest Pain Patients

Two-hour protocol may identify those suitable for early discharge

WEDNESDAY, March 23 (HealthDay News) -- A novel two-hour accelerated diagnosis protocol (ADP) appears quite accurate in identifying patients with chest pains who are at low risk for a major adverse cardiac event and could probably be discharged early, according to research published online March 23 in The Lancet.

Martin Than, M.B.B.S., of Christchurch Hospital in New Zealand, and colleagues applied the ADP, which included use of pre-test probability scoring, electrocardiograph, and biomarker tests, to 3,582 patients age 18 or older with five or more minutes of chest pain to validate safety of the ADP.

According to ADP classification, 352 (9.8 percent) of the patients were low-risk and potentially suitable for early discharge. Major adverse events occurred in three of these patients, which gave the ADP a sensitivity of 99.3 percent, a negative predictive value of 99.1 percent, and a specificity of 11 percent.

"This novel ADP identifies patients at very low risk of a short-term major adverse cardiac event who might be suitable for early discharge. Such an approach could be used to decrease the overall observation periods and admissions for chest pain. The components needed for the implementation of this strategy are widely available. The ADP has the potential to affect health-service delivery worldwide," the authors write.

The study was funded in part by Alere Medical, Medquest Jaya Global, Science International, Bio Laboratories Pte, and Progressive Group. Several authors disclosed financial relationships with these and other medical technology and/or pharmaceutical companies.

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