Cholesterol screening in the emergency department

To determine the feasibility of providing cholesterol screening in the emergency department (ED) and to determine compliance with follow-up recommendations.

A prospective observational study.

The Ambulatory Care and Treatment Section of the George Washington University Medical Center ED.

All patients seen in the Ambulatory Care and Treatment Section of the ED who were 18 years of age or older and who were residents of the metropolitan Washington, D.C., area were eligible to participate. During the six-month study period, 660 patients were asked to participate and 539 (82%) agreed.

Fingerstick cholesterol measurements were performed on all participants. Participants who had elevated cholesterol levels, as determined by the National Cholesterol Education Program guidelines, were scheduled for a six-week follow-up visit in the Lipid Research Clinic, where repeat fingerstick cholesterol measurements were performed. Those participants with elevated cholesterol levels were instructed to follow up with their primary care physicians. Compliance with follow-up was assessed by a telephone contact four months after the initial ED visit.

Of the 539 participants, 100 (19%) were found to have elevated cholesterol levels. Fifty-three (53%) returned for the six-week follow-up visit. Of the 53 who returned, 7 (13%) had normal and 46 (87%) had elevated cholesterol levels. Of the 46 participants with elevated cholesterol levels, 15 (33%) reported four months after their ED visit that they had received further follow-up care.

Cholesterol screening in the ED is feasible, but compliance with follow-up is less than desirable.