Differences between chest pain observation service patients and admitted "rule-out myocardial infarction" patients.
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1997-07
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Abstract
Objective
To compare and contrast the patient characteristics of ED patients at low risk for acute cardiac ischemia who were assigned to a chest pain observation service vs those admitted to a monitored inpatient bed for "rule-out acute myocardial infarction" (R/O MI).Methods
This was a retrospective, cross-sectional comparison of adult patients considered at relatively low risk for cardiac ischemia and who were evaluated in 1 of 2 settings: a short-term observation service and an inpatient monitored bed. All patients had an ED final diagnosis of "chest pain," "R/O MI," or "unstable angina" during the 7-month study period. Demographic features and presenting clinical features were examined as a function of site of patient evaluation.Results
Of 531 study patients, 265 (50%) were assigned to the observation service. Younger age (OR = 1.75, 95% CI 1.26, 2.44, for each decrement of 20 years), the complaint of "chest pain" (OR = 2.35, 95% CI 1.34, 4.12), and the absence of prior known coronary artery disease (OR = 1.64, 95% CI 1.13, 2.38) were the principal independent factors associated with assignment to a chest pain observation service bed.Conclusions
Patients evaluated in a chest pain observation service appear to have different clinical characteristics than other individuals admitted to a monitored inpatient bed for "R/O MI." Investigators should address differences in clinical characteristics when making outcome comparisons between these 2 patient groups.Type
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Dallara, J, HW Severance, B Davis and G Schulz (1997). Differences between chest pain observation service patients and admitted "rule-out myocardial infarction" patients. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 4(7). pp. 693–698. 10.1111/j.1553-2712.1997.tb03762.x Retrieved from https://hdl.handle.net/10161/26216.
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Scholars@Duke

Harry Wells Severance
Site Principle Investigator: PROspective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) prospective, randomized, multi-center clinical trial:
Principle Investigator - Duke E.D. Site - "Speed" Study. Pilot phase of Gusto IV. Investigating Abciximab (a GP IIb-IIIa inhibitor) in combination with rapid access to cardiac cath. Funded through Duke Clinical Research Institute. Multi-center trial.
Principle Investigator - Project: proposed mechanisms for afferent pain transmission from myocardial cells to pain centers. Purpose is to identify potential biochemical markers for early anginal presentations. Funded: grants received from Merck & Co. and Roche-Boehringer-Mannheim. Pilot phase paper - in preparation.
Other Interest Areas:
Blasts/Ballistics
Wounding and medical management of penetrating injuries derived from firearms and blast-related injuries.
Impact of Observation/short-stay strategies on clinical care and inpatient/outpatient systems.
Impact of Emerging Viral Threats on clinical management and social/economic/political systems,
Acute Cardiology - Chest Pain Presentations
Evolving Technology and AI in improving clinical care/management
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