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Who should be admitted to the chest pain observation unit?: one urban hospital experience
Yanina A Purim-Shem-Tov1, Julio C Silva, Dino P Rumoro
1Emergency Department, Rush University Medical Center, Chicago, Illinois, USA. yanina_purim-shem-tov@rush.edu
Insights
Chest pain observation units (CPOUs) safely manage low-risk coronary artery disease (CAD) patients. Patients with two or fewer risk factors are ideal candidates for CPOU, ensuring efficient and safe care.
Area of Science:
- Cardiology
- Internal Medicine
- Emergency Medicine
Background:
- Chest pain observation units (CPOUs) are effective for managing low-risk coronary artery disease (CAD).
- Understanding risk profiles is crucial for optimizing CPOU patient selection.
Purpose of the Study:
- To differentiate risk profiles between patients with positive and negative workups in a CPOU setting.
- To evaluate the safety and practicality of CPOU admissions for chest pain evaluation.
Main Methods:
- Retrospective chart review of 243 patients admitted to the CPOU over six months.
- Data collection included demographics, medical history (diabetes, hypertension, hyperlipidemia, family CAD history, smoking), and test results.
- Statistical analysis using SPSS-12 to compare patient characteristics.
Main Results:
- 86% of patients completed their workup, and 82% were discharged from the CPOU.
- 10% of patients (24 total) had a positive stress test.
- Among those with a positive stress test, 54% (13 patients) had three or more CAD risk factors.
Conclusions:
- CPOU management is practical and safe for selected patients.
- Patients with two or fewer coronary artery disease risk factors are identified as ideal candidates for CPOU admission.
Introduction:
Patients at low risk for coronary artery disease (CAD) can be safely treated in the chest pain observation unit (CPOU). The goal of the study is to identify the differences in risk profiles of patients with positive and negative workup.
Methods:
The study is a retrospective CPOU chart review conducted over 6 months. Data collected included gender, age, race, history of diabetes, hypertension, hyperlipidemia, family history of CAD, smoking, test results, and disposition. SPSS-12 program was used to analyze the differences in patient's characteristics.
Results:
Two hundred forty-three patients were admitted to CPOU, 86% completed their workup, and 82% were discharged. Twenty-four (10%) patients had positive stress test, of whom 13 (54%) had > or =3 risk factors.
Conclusion:
It is practical to admit patients to the CPOU. The study has shown that "ideal" patients for CPOU are those with < or =2 risk factors for CAD.
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