Henry Ford HEART Score Randomized Trial: Rapid Discharge of Patients Evaluated for Possible Myocardial Infarction

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Circ Cardiovasc Qual Outcomes


BACKGROUND: Hospital evaluation of patients with chest pain is common and costly. The HEART score risk stratification tool that merges troponin testing into a clinical risk model for evaluation emergency department patients with possible acute myocardial infarction (AMI) has been shown to effectively identify a substantial low-risk subset of patients possibly safe for early discharge without stress testing, a strategy that could have tremendous healthcare savings implications.

METHOD AND RESULTS: A total of 105 patients evaluated for AMI in the emergency departments of 2 teaching hospitals in the Henry Ford Health System (Detroit and West Bloomfield, MI), between February 2014 and May 2015, with a modified HEART score ≤3 (which includes cardiac troponin I

CONCLUSIONS: Among patients evaluated for possible AMI in the emergency department with a modified HEART score ≤3, early discharge without stress testing as compared with transfer to an observation unit for stress testing was associated with significant reductions in length of stay and total charges, a finding that has tremendous potential national healthcare expenditure implications.

CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT03058120.

Medical Subject Headings

Adult; Age Factors; Aged; Angina Pectoris; Biomarkers; Cause of Death; Cost Savings; Cost-Benefit Analysis; Decision Support Techniques; Electrocardiography; Emergency Service, Hospital; Female; Hospital Costs; Hospitals, University; Humans; Length of Stay; Male; Michigan; Middle Aged; Myocardial Infarction; Myocardial Revascularization; Patient Discharge; Patient Readmission; Predictive Value of Tests; Prospective Studies; Risk Assessment; Risk Factors; Time Factors; Triage; Troponin I

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