Associations between routine coronary computed tomographic angiography and reduced unnecessary hospital admissions, length of stay, recidivism rates, and invasive coronary angiography in the emergency department triage of chest pain

Journal of the American College of Cardiology

Volumn 62, Issue 6, 2013, Pages 543-552

  Poon, Michael ^a,b   Cortegiano, Michael ^a   Abramowicz, Alexander J ^a   Hines, Margaret ^a   Singer, Adam J ^a   Henry, Mark C ^a   Viccellio, Peter ^a   Hellinger, Jeffrey C ^a   Ferraro, Summer ^a   Poon, Annie ^a   Raff, Gilbert L ^c   Voros, Szilard ^a,b   Farkouh, Michael E ^d   Noack, Pamela ^b  

^a Stony Brook School of Dental Medicine   (United States)

^b STONY BROOK UNIVERSITY   (United States)

^c WILLIAM BEAUMONT HOSPITAL   (United States)

^d UNIVERSITY OF TORONTO   (Canada)

Author keywords

admission rate; chest pain; coronary computed tomographic angiography; emergency; invasive resource utilization; length of stay

Indexed keywords

ADULT; ANGIOCARDIOGRAPHY; ARTICLE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; COHORT ANALYSIS; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; CONTROLLED STUDY; CORONARY ARTERY RECANALIZATION; DISEASE ASSOCIATION; EMERGENCY HEALTH SERVICE; EMERGENCY WARD; FEMALE; HEALTH CARE UTILIZATION; HEART INFARCTION; HOSPITAL ADMISSION; HUMAN; INTERMETHOD COMPARISON; INVASIVE PROCEDURE; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MORTALITY; OBSERVATIONAL STUDY; OUTCOME ASSESSMENT; PRIORITY JOURNAL; RADIATION DOSE; RECURRENCE RISK; RETROSPECTIVE STUDY; RISK ASSESSMENT; THORAX PAIN;

ACS; ACUTE CORONARY SYNDROME(S); ACUTE MYOCARDIAL INFARCTION; ADMISSION RATE; AMI; CAD; CCTA; CHEST PAIN; CORONARY ARTERY DISEASE; CORONARY COMPUTED TOMOGRAPHIC ANGIOGRAPHY; ECG; ED; ELECTROCARDIOGRAPHY; EMERGENCY; EMERGENCY DEPARTMENT; INVASIVE RESOURCE UTILIZATION; LENGTH OF STAY; MACE; MAJOR ADVERSE CARDIOVASCULAR EVENT(S);

ADULT; AGED; CHEST PAIN; COHORT STUDIES; CORONARY ANGIOGRAPHY; DIAGNOSTIC TESTS, ROUTINE; EMERGENCY SERVICE, HOSPITAL; FEMALE; HOSPITALIZATION; HUMANS; LENGTH OF STAY; MALE; MIDDLE AGED; PATIENT READMISSION; RETROSPECTIVE STUDIES; TOMOGRAPHY, X-RAY COMPUTED; TRIAGE;

EID: 84881098817     PISSN: 07351097     EISSN: 15583597     Source Type: Journal    
DOI: 10.1016/j.jacc.2013.04.040     Document Type: Article

References (23)

1. R. Niska, F. Bhuiya, and J. Xu National Hospital Ambulatory Medical Care Survey: 2007 emergency department summary Natl Health Stat Rep 26 2010 1 31
2. V.L. Priest, P.A. Scuffham, R. Hachamovitch, and T.H. Marwick Cost-effectiveness of coronary computed tomography and cardiac stress imaging in the emergency department: a decision analytic model comparing diagnostic strategies for chest pain in patients at low risk of acute coronary syndromes J Am Coll Cardiol Img 4 2011 549 556
3. M.V. Furtado, A. Cardoso, and M.C. Patricio Influence of implementation of a chest pain unit on acute coronary syndrome outcomes J Emerg Med 40 2011 557 564
4. A.K. Venkatesh, B.P. Geisler, J.J. Gibson Chambers, C.W. Baugh, J.S. Bohan, and J.D. Schuur Use of observation care in US emergency departments, 2001 to 2008 PLoS One 6 2011 e24326
5. J.M. Miller, C.E. Rochitte, and M. Dewey Diagnostic performance of coronary angiography by 64-row CT N Engl J Med 359 2008 2324 2336
6. J.A. Goldstein, K.M. Chinnaiyan, and A. Abidov The CT-STAT (Coronary Computed Tomographic Angiography for Systematic Triage of Acute Chest Pain Patients to Treatment) trial J Am Coll Cardiol 58 2011 1414 1422
7. U. Hoffmann, F. Bamberg, and C.U. Chae Coronary computed tomography angiography for early triage of patients with acute chest pain: the ROMICAT (Rule Out Myocardial Infarction using Computer Assisted Tomography) trial J Am Coll Cardiol 53 2009 1642 1650
8. U. Hoffmann, Q.A. Truong, and D.A. Schoenfeld Coronary CT angiography versus standard evaluation in acute chest pain N Engl J Med 367 2012 299 308
9. H.I. Litt, C. Gatsonis, and B. Snyder CT angiography for safe discharge of patients with possible acute coronary syndromes N Engl J Med 366 2012 1393 1403
10. R.C. Cury, G.M. Feuchtner, and J.C. Batlle Triage of patients presenting with chest pain to the emergency department: implementation of coronary CT angiography in a large urban health care system AJR Am J Roentgenol 200 2013 57 65
11. A.J. Singer, A. Domingo, and H.C. Thode Jr. Utilization of coronary computed tomography angiography for exclusion of coronary artery disease in ED patients with low- to intermediate-risk chest pain: a 1-year experience Am J Emerg Med 30 2012 1706 1711
12. D. Rubin Using propensity scores to help design observational studies: application to the tobacco litigation Health Services Outcomes Res Methodol 2 2001 169 188
13. K.M. Takakuwa, E.J. Halpern, E.L. Gingold, D.C. Levin, and F.S. Shofer Radiation dose in a "triple rule-out" coronary CT angiography protocol of emergency department patients using 64-MDCT: the impact of ECG-based tube current modulation on age, sex, and body mass index AJR Am J Roentgenol 192 2009 866 872
14. E.A. Amsterdam, J.D. Kirk, and D.A. Bluemke Testing of low-risk patients presenting to the emergency department with chest pain: a scientific statement from the American Heart Association Circulation 122 2010 1756 1776
15. B.C. Sun, R.Y. Hsia, and R.E. Weiss Effect of emergency department crowding on outcomes of admitted patients Ann Emerg Med 61 2013 605 611
16. Edmondson The association of emergency department crowding during treatment for acute coronary syndrome with subsequent posttraumatic stress disorder symptoms JAMA Int Med 2013 1 2
17. A.J. Taylor, M. Cerqueira, and J.M. Hodgson ACCF/SCCT/ACR/AHA/ASE/ASNC/ NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance J Am Coll Cardiol 56 2010 1864 1894
18. D.E. Winchester, P. Jois, S.M. Kraft, D.C. Wymer, and J.A. Hill Immediate computed tomography coronary angiography versus delayed outpatient stress testing for detecting coronary artery disease in emergency department patients with chest pain Int J Cardiovasc Imag 28 2012 667 674
19. B.J. Chow, A. Abraham, and G.A. Wells Diagnostic accuracy and impact of computed tomographic coronary angiography on utilization of invasive coronary angiography Circulation Cardiovasc Imag 2 2009 16 23
20. R. Hachamovitch, B. Nutter, and M.A. Hlatky Patient management after noninvasive cardiac imaging results from SPARC (Study of Myocardial Perfusion and Coronary Anatomy Imaging Roles in Coronary Artery Disease) J Am Coll Cardiol 59 2012 462 474
21. M. Tavakol, S. Ashraf, and S.J. Brener Risks and complications of coronary angiography: a comprehensive review Global J Health Sci 4 2012 65 93
22. S.S. Halliburton, S. Abbara, and M.Y. Chen SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT J Cardiovasc Comput Tomogr 5 2011 198 224
23. J. Hausleiter, S. Martinoff, and M. Hadamitzky Image quality and radiation exposure with a low tube voltage protocol for coronary CT angiography results of the PROTECTION II trial J Am Coll Cardiol Img 3 2010 1113 1123