AI Article Synopsis
- The study evaluates the economic impact of an accelerated protocol (AP) for diagnosing myocardial infarction (MI) using high-sensitivity cardiac troponin (hs-cTn) compared to conventional testing methods.
- Conducted across nine emergency departments, the research analyzed costs and length of stay for nearly 32,450 patients suspected of having MI.
- Results showed that the AP did not significantly increase treatment costs or length of stay overall, but some lower acuity emergency departments experienced shorter stays and lower health system costs with the AP.
Article Abstract
Objective: Protocols to evaluate for myocardial infarction (MI) using high-sensitivity cardiac troponin (hs-cTn) have the potential to drive costs upward due to the added sensitivity. We performed an economic evaluation of an accelerated protocol (AP) to evaluate for MI using hs-cTn to identify changes in costs of treatment and length of stay compared with conventional testing.
Methods: We performed a planned secondary economic analysis of a large, cluster randomized trial across nine emergency departments (EDs) from July 2020 to April 2021. Patients were included if they were 18 years or older with clinical suspicion for MI. In the AP, patients could be discharged without further testing at 0 h if they had a hs-cTnI < 4 ng/L and at 1 h if the initial value were 4 ng/L and the 1-h value ≤7 ng/L. Patients in the standard of care (SC) protocol used conventional cTn testing at 0 and 3 h. The primary outcome was the total cost of treatment, and the secondary outcome was ED length of stay.
Results: Among 32,450 included patients, an AP had no significant differences in cost (+$89, CI: -$714, $893 hospital cost, +$362, CI: -$414, $1138 health system cost) or ED length of stay (+46, CI: -28, 120 min) compared with the SC protocol. In lower acuity, free-standing EDs, patients under the AP experienced shorter length of stay (-37 min, CI: -62, 12 min) and reduced health system cost (-$112, CI: -$250, $25).
Conclusion: Overall, the implementation of AP using hs-cTn does not result in higher costs.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10985545 | PMC |
| http://dx.doi.org/10.1002/emp2.13140 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Diagnostic Value of the Alveolar-Arterial Oxygen Gradient in Pulmonary Embolism: A Cross-Sectional Study.
Healthcare (Basel)
December 2024
School of Medicine, University of Split, 21000 Split, Croatia.
: Pulmonary embolism (PE) is a potentially serious condition characterized by the blockage of blood vessels in the lungs, often presenting significant diagnostic challenges due to its non-specific symptoms. This study aimed to evaluate the utility of the alveolar-arterial (A-a) oxygen gradient as a diagnostic tool for PE, hypothesizing that it could enhance early detection when combined with other clinical markers. : We retrospectively analyzed 168 patients at the University Hospital Center Split.
View Article and Find Full Text PDFPrognostic value of biomarkers of ischaemia in patients with peripheral arterial disease following endovascular revascularisation.
Vasa
January 2025
Department of Vascular Diseases, University Medical Centre Ljubljana, Slovenia.
Our aim was to evaluate the prognostic value of detectable high-sensitivity cardiac troponin I (hs-cTnI) and ischaemia-modified albumin (IMA) in predicting all-cause death or non-fatal ischaemic events in patients with PAD after endovascular revascularisation of the lower limbs. Patients who underwent successful endovascular revascularisation for chronic limb-threatening ischaemia (CLTI) or disabling intermittent claudication (IC) were prospectively included. Pre-procedural levels of hs-cTnI and IMA were measured, and patients were followed for one year for the occurrence of the composite outcome of all-cause death, non-fatal myocardial infarction, new-onset angina, non-fatal ischaemic stroke, transient ischaemic attack, or progression of PAD.
View Article and Find Full Text PDFPregnancy & cardiovascular disease: the PREG-CVD-HH registry.
Cardiovasc Diagn Ther
December 2024
Department of Cardiology, University Heart & Vascular Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Background: Cardiovascular disease (CVD) remains the leading cause of death in pregnant and peripartal women in western countries. Physiological changes during pregnancy can lead to cardiovascular complications in the mother; women with pre-existing heart disease may not tolerate these changes well, increasing their susceptibility to adverse cardiovascular outcomes during pregnancy. The aim of this study is to characterize pregnancy-induced changes in cardiac function, biomarker concentrations and cardiovascular outcomes in women with CVD during pregnancy at a tertiary care hospital in Germany.
View Article and Find Full Text PDFReliability and Accuracy of the Fitbit Charge 4 Photoplethysmography Heart Rate Sensor in Ecological Conditions: Validation Study.
JMIR Mhealth Uhealth
January 2025
ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Univ. Littoral Côte d'Opale, Univ. Lille, Univ. Artois, 189b, Avenue Maurice Schumann, Centre Universitaire des Darses, Dunkerque, 59375, France, 33 328237357.
Background: Wrist-worn photoplethysmography (PPG) sensors allow for continuous heart rate (HR) measurement without the inconveniences of wearing a chest belt. Although green light PPG technology reduces HR measurement motion artifacts, only a limited number of studies have investigated the reliability and accuracy of wearables in non-laboratory-controlled conditions with actual specific and various physical activity movements.
Objective: The purpose of this study was to (1) assess the reliability and accuracy of the PPG-based HR sensor of the Fitbit Charge 4 (FC4) in ecological conditions and (2) quantify the potential variability caused by the nature of activities.
The impact of new-onset atrial fibrillation in the setting of acute coronary syndrome.
J Cardiol
January 2025
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China; Kent and Medway Medical School, Canterbury, Kent, UK; School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China.
Approximately 10 % of patients who have suffered from myocardial infarction develop new-onset atrial fibrillation (AF). Coronary artery disease implicating atrial branches has been associated with AF. The following variables have been associated with new-onset AF in the setting of acute coronary syndrome: older age, history of hypertension, history of angina, history of stroke, chronic renal failure, body mass index, no statin use, worse nutritional status, worse Killip class, admission heart rate ≥ 85 bpm, complete atrioventricular block, Glasgow prognostic score, Syntax score, CHEST score > 3, PRECISE-DAPT score ≥ 25, left ventricular ejection fraction ≤40 %, increased left atrial diameter, E/E' ratio > 12, epicardial fat tissue thickness, and thrombolysis in myocardial infarction flow <3.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!