NDLI: Structure, process and outcomes of chest pain units established in the ESCAPE trial.

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Structure, process and outcomes of chest pain units established in the ESCAPE trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Arnold, Jane Goodacre, Steve Morris, Francis
Description	Country affiliation: United kingdom Author Affiliation: Arnold J ( Medical Care Research Unit, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. j.a.arnold@sheffield.ac.uk)
Abstract	BACKGROUND: Chest pain units (CPUs) provide a system of care for patients with acute chest pain that can improve outcomes while reducing health service costs. The Effectiveness and Safety of Chest Pain Assessment to Prevent Emergency Admissions (ESCAPE) multicentre trial was undertaken to determine whether CPUs could be successfully established throughout the National Health Service (NHS). AIM: To describe the structure, processes and outcomes of patients managed by CPUs in the ESCAPE Trial. METHOD: 7 of 14 participating hospitals were randomly allocated to establish CPU care. Each hospital set up a CPU using standardised protocols to provide biochemical cardiac marker and exercise treadmill testing for low-risk patients. Research staff then followed up patients for 30 days to identify any adverse events, defined as chest pain-related readmission to hospital for more than 48 h, non-fatal myocardial infarction and all deaths. RESULTS: The 7 units managed a total of 1644 patients during their first year of operation. Activity varied from 1 to 7 patients per 1000 adult emergency department attendances. Overall, 1374 (83%) patients were discharged after CPU assessment, with 23 (1.7%) adverse events recorded among those discharged. Some, but not all, of the variation in activity could be attributed to hospital size and patient selection. CONCLUSION: CPU care can be instituted in a safe manner at a variety of NHS hospitals, with most patients being discharged after assessment. However, there is variation in the number and type of patients managed by the different units. Further research is required to identify reasons for variation in CPU activity.
File Format	HTM / HTML
ISSN	14720205
e-ISSN	14720213
Journal	Emergency Medicine Journal
Issue Number	7
Volume Number	24
Language	English
Publisher	BMJ Publishing Group Ltd
Publisher Date	2007-07-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Emergency Discipline Medicine Chest Pain Therapy Hospital Units Organization & Administration Acute Disease Blood Chemical Analysis Clinical Protocols Emergencies Multicenter Study Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine Critical Care and Intensive Care Medicine

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