Outcomes in patients with myocardial infarction who are initially admitted to stepdown units: Data from the multicenter chest pain study

Fiebach, Nicholas H.; Cook, E. Francis; Lee, Thomas H.; Brand, Donald A.; Rouan, Gregory W.; Weisberg, Monica; Goldman, Lee

doi:10.1016/0002-9343(90)90091-q

Cited by 56 publications

(23 citation statements)

References 30 publications

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“…The preferred site of care for patients with acute myocardial infarction remains the coronary care unit, and no randomized trial has been performed to test coronary care units versus lower levels of care. One analysis of data from 467 patients with myocardial infarction did not find any evidence that patients with myocardial infarction have worse outcomes if they are initially triaged to intermediate care units [5]. In this study, serious complications occurred in 28% of the patients who were triaged to stepdown units compared with 39% of coronary care unit patients.…”

Section: A New Management Strategycontrasting

confidence: 61%

Emergency department observation units: Has the time come?

Lee

1996

J Thromb Thrombol

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Background: Economic pressures for efficiency in health care have led to the need for new strategies for the care of patients with acute chest pain. Methods: Chest pain observation units have been developed in many hospitals and are widely considered to have the potential to provide rapid and safe evaluations for low-risk patients with acute chest pain. Critical pathways are also an increasingly used strategy for the management of this patient population. Results: Available data suggest that chest pain observation units can decrease 6 month resource utilization compared with patients admitted to traditional sites of care. However, the potential exists for these units to increase resource utilization by encouraging admissions to the hospital of patients who otherwise would have been discharged directly home. Conclusions: Chest pain observation units appear to be an important innovation for the care of patients with a low risk for acute myocardial infarction. Use of guidelines for the se units may permit true increases in efficiency without compromising quality.

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Section: A New Management Strategycontrasting

confidence: 61%

Emergency department observation units: Has the time come?

Lee

1996

J Thromb Thrombol

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“…Additional articles found through a citation search of the significant methods articles written about PS, using Science Citation Index, yielded 13 medical research studies that used PS in 2003 [163][164][165][166][167][168][169][170][171][172][173][174][175], 13 in 2002 [176][177][178][179][180][181][182][183][184][185][186][187][188], 11 in 2001 [189][190][191][192][193][194][195][196][197][198][199], 3 in 2000 [200][201][202], 1 in 1999 [203], 3 in 1998 [204][205][206], and a total of 3 before 1998 [207][208][209]. We present the number of studies with results based on PS methods published in each of these years in …”

Section: Resultsmentioning

confidence: 99%

A review of the application of propensity score methods yielded increasing use, advantages in specific settings, but not substantially different estimates compared with conventional multivariable methods

Stürmer

Joshi

Glynn

et al. 2006

Journal of Clinical Epidemiology

578

497

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“…Since then, the number of CPUs has grown continuously worldwide, and Dr. Bahr's original concept has evolved into many forms, varying greatly from the original concept. Some of the more common names that have been adopted are chest pain emergency room, chest pain emergency department, chest pain centre, chest pain clinic, chest pain attack unit, chest pain evaluation unit, heart emergency room, short stay ED coronary care unit, and ED monitored observation bed [13,[25][26][27][28][29][30]. The clinical and cost effectiveness of the CPU concept has been investigated extensively.…”

Section: Introductionmentioning

confidence: 99%

The Role of Nurses in a Chest Pain Unit

Siebens

Moons

Geest

et al. 2007

European Journal of Cardiovascular Nursing

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The chest pain unit (CPU) provides a service for patients at moderate-to-low risk for acute coronary syndrome (ACS). Although the number of CPUs has continued to grow worldwide, little has been written on the specific role and contribution of nursing in CPUs. The stay of patients in the CPU can be divided into six stages: triage, diagnosis, treatment, observation/monitoring, discharge, and follow-up. CPU nurses are in a unique position to promote evidence-based practice during all of these stages. Deeper insight into the unique role of nurses in CPUs will promote understanding of what type of knowledge, skills, and attitudes are required to provide the services that will contribute to improved quality of care for chest pain patients.

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Outcomes in patients with myocardial infarction who are initially admitted to stepdown units: Data from the multicenter chest pain study

Cited by 56 publications

References 30 publications

Emergency department observation units: Has the time come?

Emergency department observation units: Has the time come?

A review of the application of propensity score methods yielded increasing use, advantages in specific settings, but not substantially different estimates compared with conventional multivariable methods

The Role of Nurses in a Chest Pain Unit

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