The iterative lessons from our studies suggest that creation of a chest pain center alone will not change the practice of chest pain management by most physicians.
In 1993 we established a chest pain center ; in mid-1995 we established a patient management algorithm directing intermediate-risk patients to the chest pain center rather than admit them to the hospital.
The creation of a chest pain center did not reduce the rate of chest pain admission by mid-1995.
After the patient management algorithm was created, admittances dropped by a rate of 21% (p<0.001) and chest pain center usage increased by+1,726% (p<0.001).
Among the 473 patients treated and discharged in the chest pain center after mid-1995,333 (70%) were considered intermediate risk.
No patient died after discharge from the chest pain center and there was 1 non-Q-wave myocardial infarction.
We conclude that a chest pain management algorithm in a chest pain center can be safe, yet effective, for identifying high-risk patients for admission and low-risk patients for discharge.
Mots-clés Pascal : Douleur, Thorax, Hôpital, Centre santé, Homme, Conduite à tenir, Algorithme, Aide diagnostic, Aide thérapeutique, Exploration, Etats Unis, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Pain, Thorax, Hospital, Health center, Human, Clinical management, Algorithm, Diagnostic aid, Therapeutic assistance, Exploration, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0213680
Code Inist : 002B12A03. Création : 16/11/1999.