Differences in triage thresholds for patients presenting with possible acute coronary syndromes: More than meets the eye

Journal of Investigative Medicine

Volumn 54, Issue 2, 2006, Pages 76-85

  Milch, Catherine E ^a   Kent, David M ^a   Ruthazer, Robin ^a   Pope, J Hector ^b   Aufderheide, Thomas P ^c   McNutt, Robert A ^d   Selker, Harry P ^a  

^a TUFTS MEDICAL CENTER   (United States)

^b Baystate Med Cent   (United States)

^c MEDICAL COLLEGE OF WISCONSIN   (United States)

^d RUSH UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

Acute coronary syndrome; Emergency department triage; Evaluation; Institutional factors; Public private hospitals; Quality of care

Indexed keywords

ACUTE CORONARY SYNDROME; ADULT; AGED; ARTICLE; CORONARY CARE UNIT; EMERGENCY HEALTH SERVICE; ETHNIC GROUP; FEMALE; FUNDING; HEALTH CARE QUALITY; HUMAN; MAJOR CLINICAL STUDY; MALE; PRIVATE HOSPITAL; PUBLIC HOSPITAL;

ACUTE DISEASE; CORONARY DISEASE; EMERGENCY SERVICE, HOSPITAL; FEMALE; HUMANS; MALE; MIDDLE AGED; ODDS RATIO; PATIENT ADMISSION; PROSPECTIVE STUDIES; REGRESSION ANALYSIS; TRIAGE;

EID: 33644792268     PISSN: 17088267     EISSN: None     Source Type: Journal    
DOI: 10.2310/6650.2006.05036     Document Type: Article

References (43)

1. Pozen MW, D'Agostino RB, Selker HP, et al. A predictive instrument to improve coronary-care-unit admission practices in acute ischemic heart disease. A prospective multicenter clinical trial. N Engl J Med 1984;310:1273-8.
2. Goldman L, Weinberg M, Weisberg M, et al. A computer-derived protocol to aid in the diagnosis of emergency room patients with acute chest pain. N Engl J Med 1982;307:588-96.
3. McCarthy BD, Wong JB, Selker HP. Detecting acute cardiac ischemia in the emergency department: a review of the literature. J Gen Intern Med 1990;5:365-73.
4. Selker HP, Beshansky JR, Griffith JL, et al. Use of the Acute Cardiac Ischemia Time-Insensitive Predictive instrument (ACI-TIPI) to assist with triage of patients with chest pain or other symptoms suggestive of acute cardiac ischemia: a multicenter, controlled clinical trial. Ann Intern Med 1998;129:845-55.
5. McCarthy BD, Beshansky JR, D'Agostino RB, Selker HP. Missed diagnoses of acute myocardial infarction in the emergency department: results from a multicenter study. Ann Emerg Med 1993;22:579-82.
6. Lee TH, Rouan GW, Weisberg MC, et al. Clinical characteristics and natural history of patients with acute myocardial infarction discharged from the emergency room. Am J Cardiol 1987;60:219-24.
7. Pope JH, Aufderheide TP, Ruthazer R, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med 2000;342:1163-70.
8. Maynard C, Beshansky JR, Griffith JL, Selker HP. Causes of chest pain and symptoms suggestive of acute cardiac ischemia in African-American patients presenting to the emergency department: a multicenter study. J Natl Med Assoc 1997;89:665-71.
9. Fleming C, D'Agostino RB, Selker HP. Is coronary-care-unit admission restricted for elderly patients? A multicenter study. Am J Public Health 1991;81:1121-6.
10. Cox JL, Chen E, Naylor CD. Revascularization after acute myocardial infraction: impact of hospital teaching status and on-site invasive facilities. J Gen Intern Med 1994;9:674-8.
11. Weitzman S, Cooper L, Chambless L, et al. Gender, racial and geographic differences in the performance of cardiac diagnostic and therapeutic procedures for hospitalized acute myocardial infarction in four states. Am J Cardiol 1997;79:722-6.
12. Iezzoni LI, Shwartz M, Moskowitz MA, et al. Illness severity and costs of admissions at teaching and nonteaching hospitals. JAMA 1990;264:1426-31.
13. Kahn KL, Pearson ML, Harrison ER, et al. Health care for black and poor hospitalized Medicare patients. JAMA 1994;271:1169-74.
14. Polanczyk CA, Lane A, Coburn M, et al. Hospital outcomes in major teaching, minor teaching and nonteaching hospitals in New York state. Am J Med 2002;112:255-61.
15. Allison JJ, Kiefe CI, Weissman NW, et al. Relationship of hospital teaching status with quality of care and mortality for Medicare patients with acute MI. JAMA 2000;284:1256-62.
16. Yedida MJ. The impact of social factors on the content of care: treatment of ischemic heart disease at a public and a voluntary hospital. Arch Intern Med 1992;152:595-600.
17. Rosenthal GE, Vaughan Sarrazin M, Hannan EL. In-hospital mortality following coronary artery bypass graft surgery in Veterans Health Administration and private sector hospitals. Med Care 2003;41:522-35.
18. Kressin NR, Petersen LA. Racial differences in the use of invasive cardiovascular procedures: review of the literature and prescription for future research. Ann Intern Med 2001;135:352-66.
19. Leape LL, Hilborne LH, Bell R, et al. Underuse of cardiac procedures: do women, ethnic minorities, and the uninsured fail to receive needed revascularization? Ann Intern Med 1999;130:183-92.
20. Gillum RF, Fortmann SP, Prineas RJ, Kottke TE. International diagnostic criteria for acute myocardial infarction and acute stroke. Am Heart J 1984;108:150-8.
21. Campeau L. Grading of angina pectoris. Circulation 1976;54:522-3.
22. Killip T, Kimball JT. Treatment of myocardial infarction in a coronary care unit: a two-year experience with 250 patients. Am J Cardiol 1967;20:457-64.
23. Selker HP, Griffith JL, D'Agostino RB. A tool for judging coronary care unit admission appropriateness, valid for both real-time and retrospective use: a time-insensitive predictive instrument (TIPI) for acute cardiac ischemia: a multicenter study [published erratum appears in Med Care 1992;30:188]. Med Care 1991;29:610-27.
24. D'Agostino RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 1998;17:2265-81.
25. Selker HP, Griffith JL, D'Agostino RB. A time-insensitive predictive instrument for acute myocardial infarction mortality: a multicenter study. Med Care 1991;29:1196-211.
26. Tyrance PH Jr, Himmelstein DU, Woolhandler S. US emergency department costs: no emergency. Am J Public Health 1996;86:1527-31.
27. Keeler EB, Rubenstein LV, Kahn KL. Hospital characteristics and quality of care. JAMA 1992;268:1709-14.
28. Yuan Z, Cooper GS, Einstadter D, et al. The association between hospital type and mortality and length of stay: a study of 16.9 million hospitalized Medicare beneficiaries. Med Care 2000;38:231-45.
29. Hartz AJ, Krakauer H, Kuhn EM, et al. Hospital characteristics and mortality rates. N Engl J Med 1989;321:1720-5.
30. O'Connor GT, Quinton HB, Traven ND, et al. Geographic variation in the treatment of acute myocardial infarction: the Cooperative Cardiovascular Project. JAMA 1999;281:627-33.
31. Subramanian U, Weinberger M, Eckert GJ, et al. Geographic variation in health care utilization and outcomes in veterans with acute myocardial infarction. J Gen Intern Med 2002;17:604-11.
32. Jencks SF, Cuerdon T, Burwen DR, et al. Quality of medical care delivered to Medicare beneficiaries: a profile at state and national levels. JAMA 2000;284:1670-6.
33. Garg PP, Landrum B, Normand ST, et al. Understanding individual and small area variation in the underuse of coronary angiographies following acute myocardial infarction. Med Care 2002;40:614-26.
34. Weitzman S, Cooper L, Chambless L, et al. Gender, racial, and geographic differences in the performance of cardiac diagnostic and therapeutic procedures for hospitalized acute myocardial infarction in four states. Am J Cardiol 1997;79:722-6.
35. Hannan EL, Kilburn H Jr, O'Donnell JF, et al. Interracial access to selected cardiac procedures for patients hospitalized with coronary artery disease in New York State. Med Care 1991;29:430-41.
36. Burstin HR, Lipsitz SR, Brennan TA. Socioeconomic status and risk for substandard medical care. JAMA 1992;268:2383-7.
37. Ayanian JZ, Udvarhelyi IS, Gatsonis CA, et al. Racial differences in the use of revascularization procedures after coronary angiography. JAMA 1993;269:2642-6.
38. Giles WH, Anda RF, Casper ML, et al. Race and sex differences in rates of invasive cardiac procedures in US hospitals. Data from the National Hospital Discharge Survey. Arch Intern Med 1995;155:318-24.
39. Taylor HA Jr, Canto JG, Sanderson B, et al. Management and outcomes for black patients with acute myocardial infarction in the reperfusion era. National Registry of Myocardial Infarction 2 Investigators. Am J Cardiol 1998;82:1019-23.
40. Hannan EL, van Ryn M, Burke J, et al. Access to coronary artery bypass surgery by race/ethnicity and gender among patients who are appropriate for surgery. Med Care 1999;37:68-77.
41. Barnhart JM, Fang J, Alderman MH. Differential use of coronary revascularization and hospital mortality following acute myocardial infarction. Arch Intern Med 2003;163:461-6.
42. Bradley EH, Herrin J, Wang Y, et al. Racial and ethnic differences in time to acute reperfusion therapy for patients hospitalized with myocardial infarction. JAMA 2004;292:1563-72.
43. Daumit GL, Hermann JA, Coresh J, Powe NR. Use of cardiovascular procedures among black persons and white persons: a 7-year nationwide study in patients with renal disease. Ann Intern Med 1999;130:173-82.