Unidades de dolor torácico: estado actual del manejo de pacientes con dolor torácico en los servicios de urgencias

Bassan, Roberto; Gibler, W. Brian

doi:10.1016/s0300-8932(01)76457-3

Cited by 25 publications

(5 citation statements)

References 64 publications

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“… 66 This can be achieved with the use of joint diagnostic protocols by ED and cardiology physicians, who have a specialized interest in this area. 54 , 67 …”

Section: Discussionmentioning

confidence: 99%

Retrospective review of non-ST segment elevation acute coronary syndrome presenting to the emergency department of a major tertiary center in Saudi Arabia

Qureshi,

Ahmed,

Ahmed

et al. 2024

Ann Saudi Med

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BACKGROUND: Acute coronary syndrome (ACS) comprises a spectrum of diseases ranging from unstable angina (UA), non-ST elevation myocardial infarction (non-STEMI) and ST elevation myocardial infarction (STEMI). Treatment of ACS without STEMI (NSTEMI-ACS) can vary, depending on the severity of presentation and multiple other factors. OBJECTIVE: Analyze the NSTEMI-ACS patients in our institution. DESIGN: Retrospective observational SETTING: A tertiary care institution with accredited chest pain center PATIENTS AND METHODS: The travel time from ED booking to the final disposition for patients presenting with chest pain was retrieved over a period of 6 months. The duration of each phase of management was measured with a view to identify the factors that influence their management and time from the ED to their final destination. The data was analyzed using descriptive statistics. MAIN OUTCOME MEASURES: Travel time from ED to final destination SAMPLE SIZE: 300 patients RESULTS: The majority of patients were males (64%) between 61 and 80 years of age (45%). The median disposition time (from ED booking to admission order by the cardiology team) was 5 hours and 19 minutes. Cardiology admissions took 10 hours and 20 minutes from ED booking to the inpatient bed. UA was diagnosed in 153 (51%) patients and non-STEMI in 52 (17%). Coronary catheterization was required in 79 (26%) patients, 24 (8%) had coronary artery bypass grafting (CABG) and 8 (3%) had both catheterization and CABG. CONCLUSION: The time from ED booking to final destination for NSTEMI-ACS patients is delayed due to multiple factors, which caused significant delays in overall management. Additional interventional steps can help improve the travel times, diagnosis, management and disposition of these patients. LIMITATIONS: Single center study done in a tertiary care center so the results from this study may not be extrapolated to other centers.

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“… 66 This can be achieved with the use of joint diagnostic protocols by ED and cardiology physicians, who have a specialized interest in this area. 54 , 67 …”

Section: Discussionmentioning

confidence: 99%

Retrospective review of non-ST segment elevation acute coronary syndrome presenting to the emergency department of a major tertiary center in Saudi Arabia

Qureshi,

Ahmed,

Ahmed

et al. 2024

Ann Saudi Med

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“…La necesidad de hospitalización estuvo dada principalmente por patología cardiovascular, concentrada principalmente en la población masculina entre los 61 y 80 años, lo que coincide con estudios similares en poblaciones también parecidas 15,16 .…”

Section: Discussionunclassified

Consultas por dolor torácico en el servicio de urgencia hospitalario de una comunidad rural. Llay-Llay 2005-2007

Muñoz

Fuente

2010

Revista Chilena De Salud Pública

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“…Esto ha ocasionado una sobre hospitalización muchas veces orientada a descartar un probable evento coronario agudo tras una primera evaluación negativa en el Servicio de Urgencia lo que se asocia a costos elevados para los sistemas de salud. Debido a esto y a la variedad de patologías potencialmente graves que subyacen a este síntoma, se han establecido unidades de evaluación denominadas Unidades de Dolor Torácico (UDT) con el fi n de: disminuir el error diagnóstico en estos pacientes, establecer una aproximación costo-efectiva para este problema, y reducir los tiempos de re-perfusión coronaria en pacientes de alto riesgo 5,6 . Estas unidades se han desarrollado alrededor del mundo en forma progresiva desde los años 80´ con un auge importante en Estados Unidos donde se dispone la mayor cantidad de datos actuales.…”

Section: Marcoleta 367unclassified

“…Mortality among women and men with CD was 28 and 14% respectively (p = 0,02). Predictor variables for mortality were the presence of a complete left branch block in the initial electrocardiogram, with an odds ratio (OR) of 12,5 (95% confi dence intervals (CI): 1,98-25,8), the presence of coronary disease with an OR of 3,98 (95% CI: 1,8) and elevated troponin I with an OR 2,12 (95% CI: 1,[5][6][7]89). Female gender lost signifi cance in the adjusted model.…”

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confidence: 99%

Seguimiento alejado de pacientes evaluados en una Unidad de Dolor Torácico

et al. 2010

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Background: Chest pain (CT) constitutes an important cause of consultation and diagnostic dilemma in the emergency room, especially due to the possible presence of coronary disease. Its presentation, diagnosis and prognosis are different between men and women. Aim: To report a follow-up of patients attended at a Chest Pain Unit (CPU), evaluating gender differences. Material and Methods: Prospective evaluation of patients that consulted for chest pain in a period of 4 years. Baseline characteristics and the fi nal diagnosis from CPU or hospitalization were registered. Telephonic follow-up was performed for at least one year. Mortality was determined using the national mortality registry. Results: A total of 1,168 patients aged 62 ± 23 years, 69 % men, were followed for a mean of 28 ± 20 months. A defi nitive diagnosis of coronary disease (CD) was done in 32 %. Mortality among women and men with CD was 28 and 14% respectively (p = 0,02). Predictor variables for mortality were the presence of a complete left branch block in the initial electrocardiogram, with an odds ratio (OR) of 12,5 (95% confi dence intervals (CI): 1,98-25,8), the presence of coronary disease with an OR of 3,98 (95% CI: 1,8) and elevated troponin I with an OR 2,12 (95% CI: 1,[5][6][7]89). Female gender lost signifi cance in the adjusted model. Conclusions: Complete left branch block, elevated troponin I and coronary etiology of CP are indicators of bad prognosis among patients that consult for CP. Women have twice the mortality of men after 28 months of follow-up. (Rev Med Chile 2010; 138: 1117-1123.

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Unidades de dolor torácico: estado actual del manejo de pacientes con dolor torácico en los servicios de urgencias

Cited by 25 publications

References 64 publications

Retrospective review of non-ST segment elevation acute coronary syndrome presenting to the emergency department of a major tertiary center in Saudi Arabia

Retrospective review of non-ST segment elevation acute coronary syndrome presenting to the emergency department of a major tertiary center in Saudi Arabia

Consultas por dolor torácico en el servicio de urgencia hospitalario de una comunidad rural. Llay-Llay 2005-2007

Seguimiento alejado de pacientes evaluados en una Unidad de Dolor Torácico

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