Association Between Noninvasive Testing for Chest Pain and Length of Hospital Stay

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During the 28-day study period, patients who underwent clinical evaluation alone experienced a shorter LOS.
During the 28-day study period, patients who underwent clinical evaluation alone experienced a shorter LOS.

HealthDay News — Noninvasive cardiac testing leads to longer length of stay (LOS) for patients presenting to the emergency department with chest pain, according to a study published in JAMA Internal Medicine to coincide with the American Heart Association's Scientific Sessions, held November 11 to 15 in Anaheim, California.

Samuel W. Reinhardt, MD, from Washington University School of Medicine in St. Louis, and colleagues examined differences in outcomes with clinical evaluation and noninvasive testing (coronary computed tomographic angiography [CCTA] or stress testing) versus clinical evaluation alone in an analysis of 1000 patients who presented to the emergency department with chest pain.

The researchers found that during the 28-day study period, patients who underwent clinical evaluation alone experienced a shorter LOS (20.3 hours vs 27.9 hours), lower rates of diagnostic testing and angiography (2% vs 11%), lower median costs ($2,261.50 vs $2,584.30), and less cumulative radiation exposure (0 mSv vs 9.9 mSv).

In the 28-day follow-up period, there was no difference in the rates of percutaneous coronary intervention, coronary artery bypass surgery, return emergency department visits, or major adverse cardiac events.

"Noninvasive cardiac testing in addition to clinical evaluation leads to longer stay, more downstream testing, more radiation exposure, and greater cost without evidence of improving clinical outcomes," the authors write.

Reference

Reinhardt SW, Lin CJ, Novak E, et al. Noninvasive cardiac testing vs clinical evaluation alone in acute chest pain [published online November 14, 2017.] JAMA Intern Med. doi: 10.1001/jamainternmed.2017.7360

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