Royal Brisbane and Women’s Hospital (RBWH) Emergency Physician Associate Professor Louise Cullen and Cardiologist Dr William Parsonage are leading ground-breaking cardiology research, reducing the amount of time possible heart attack patients spend in the emergency department.
The research, recently published in the influential medical journal ‘Journal of the American College of Cardiology’, has found a reliable and rapid process to identify a large group of patients with chest pain who are at very low risk of a heart attack.
Every year in Australia an estimated 500,000 emergency department presentations are for symptoms suggestive of a heart attack.
Ultimately only one in five of these patients will have serious heart disease but trying to identify the healthy patients has been difficult.
In the past these patients would be admitted to hospital for at least 12 to 24 hours to undergo a series of tests which causes stress and anxiety on the patient and required significant hospital resources.
A/Prof Cullen and Dr Parsonage have established a new, fast protocol that incorporates a specialised blood test (highly sensitive troponin I) two hours after arrival to rule out serious heart disease in a very large proportion of patients presenting to emergency departments with a possible heart attack.
“With the use of this protocol, unnecessary hospital admissions could be safely avoided in around 40 per cent of these patients, reducing patient anxiety and inconvenience, and reducing inefficient use of hospital resources,” A/Prof Cullen said.
“If we can identify people who don’t need to be in hospital it reduces their stress and heartache and frees up hospital resources for the patients who need it the most.”
Initially, in collaboration with Christchurch Cardio-Endocrine Research Group in New Zealand, the team tested this protocol in 1635 patients. To ensure their findings were applicable around the world, they worked with Prof. Christian Mueller in Basal, Switzerland, where he was able to reproduce these same great results.
This new protocol offers a great opportunity for change in established clinical practices.
A/Prof Cullen and Dr Parsonage are now continuing further interventional research at RBWH which looks at assessing the ability to accelerate the diagnostic process for the patients who have already been admitted.
“While the study just published is showing that 40 per cent of chest pain presentations can be discharged in two hours, early findings in our new research is suggesting that for those patients who do require additional investigations, we can safely reduce their hospital stay from over 24 hours to less than 8 hours,” A/Prof Cullen said.
“Obtaining an earlier diagnosis will free up beds and help to streamline the care for patients who require admission.”
A/Prof Cullen’s research has been funded by the Queensland Emergency Medicine Research Foundation.
Source: Queensland Health