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- Title
Coronary Computed Tomography Angiography Service in the Accident and Emergency Department: Pilot Study.
- Authors
Chau, H. H. T.; Luk, W. H.; Ma, J. K. F.; She, H. H. L.; Lam, M. C.; Li, Y. K.; Chan, C. M.; Wong, W. C. L.
- Abstract
Introduction: Studies in western countries have shown that installation of coronary computed tomography angiography (CCTA) in the accident and emergency department (AED) facilitates safe triage and early discharge of low-to-intermediate risk patients with suspected acute coronary syndrome. The aim of this pilot study was to determine whether the workflow of a CCTA service in a local hospital AED could safely discharge low-to-intermediate risk patients presenting with acute chest pain. Methods: Low-to-intermediate risk chest pain patients (stratified using the HEART score), who underwent CCTA in the AED, were included. Patient health records were followed up for 2 years. Clinical variables, time needed for diagnosis, CCTA results, and major adverse cardiac events (MACE) were evaluated. Results: Thirty-four patients (17 men, 17 women) were included in this study from March to August 2017. Nineteen patients (55.9%) were low-risk and 15 (44.'%) were intermediate-risk. Mean time to CCTA was 39.2 ±27.9 hours. Twenty-four patients (70.6%) with negative CCTA results (<50% coronary artery stenosis) were discharged home from AED and 10 patients (29.4%) with positive result (≥50% stenosis) were admitted to medical wards for further assessment. In the 2-year follow-up period, no MACE was found in the negative group. For MACE in the positive group, no cardiac death, one non-fatal myocardial infarction (contraindicated for revascularisation) and five revascularisations were noted. Conclusion: CCTA allows safe discharge of low-to-intermediate risk patients presenting with acute chest pain in the AED. An AED CCTA service is effective in reducing the waiting time and length of stay.
- Subjects
CORONARY arterial radiography; ACCIDENTS; PILOT projects; LENGTH of stay in hospitals; BLOOD vessels; HOSPITAL emergency services; CHEST pain; CORONARY artery disease; COMPUTED tomography; SYMPTOMS
- Publication
Hong Kong Journal of Radiology, 2022, Vol 25, Issue 1, p45
- ISSN
2223-6619
- Publication type
Article
- DOI
10.12809/hkjr2217287