Chest pain? New method sharply reduces admissions

The number of patients with chest pain arriving at the emergency room could be reduced by tens of thousands every year. Research by the Radboudumc in Nijmegen shows that patients with a low risk of a heart attack can be examined at home by ambulance staff, without adverse effects on their health.

Not everyone with chest pain needs to go to hospital for this. Patients with a low risk of myocardial infarction can be examined at home by ambulance staff, with no adverse effects on their health. This course of action not only saves admissions, but also millions of euros in healthcare costs.

It also saves hassle for patient and is less crowded in the emergency room. Annually, ambulances transport around 200,000 people with chest pain to the hospital. Once there, it turns out that 80 to 90 per cent of these people do not have a heart problem. They are then allowed to return home.

High risk of heart problems

Cardiologists at Radboudumc investigated the possibility of initially examining these patients at home and only sending them on in case of a high risk of, for instance, a heart attack. They found that hospital visits are often unnecessary because there is no heart problem.

Nearly 900 people with chest pain participated in the study. Ambulance staff assessed their risk of a heart problem based on symptoms, age, risk factors and a cardiac ultrasound (ECG). At high risk of a heart attack, a patient went straight to hospital. At low risk, they analysed the amount of troponin in the blood. This protein is released when the heart is damaged and is an indication of impending heart attack.

Chances small of still having heart problem

When troponin levels were high, a patient went directly to hospital. For low levels, the patient remained at home, provided with further instructions such as contacting the GP. All patients were then followed up to 30 days after the event and it was checked whether a heart problem still occurred. The chances of this turning out to be very low.

Physician-researcher Joris Aarts: "Low-risk heart attack patients can generally stay safely at home. This is good news because an emergency ambulance ride and hospital admission are drastic events. Now we know that it is often unnecessary."

In addition, this new analysis at the patient's home reduces healthcare costs. The researchers calculated that it saves more than 600 euros per patient if they do not have to go to hospital.

The results of the study have been published in the European Heart Journal.

Source: Healthnet.co.uk