PMID- 22051768
OWN - NLM
STAT- MEDLINE
DCOM- 20120824
LR  - 20211020
IS  - 1615-6692 (Electronic)
IS  - 0340-9937 (Linking)
VI  - 37
IP  - 3
DP  - 2012 May
TI  - [The length of hospital stay in patients with acute coronary syndrome is reduced 
      by establishing a chest pain unit].
PG  - 301-7
LID - 10.1007/s00059-011-3544-2 [doi]
AB  - BACKGROUND: Providing prompt and appropriate therapy, combined with the increased 
      economic requirements of treating patients with acute coronary syndrome (ACS), 
      places high demands on the emergency department. The aim of the present analysis 
      is to evaluate to what extent establishing a dedicated chest pain unit (CPU) 
      influences the length of hospital stay in ACS patients. METHODS: Patients 
      presenting with suspected ACS between 05/2004 and 05/2006 to either the emergency 
      department (ED) or the newly established CPU were retrospectively analyzed. The 
      CPU became functional in July 2005. Data were obtained according to standardized 
      procedures based on patient charts and all available clinical information. 
      RESULTS: A total of 247 patients were treated in the ED and 765 in the CPU. In 
      the ED patient group 29 (11.7%) were diagnosed with ST elevation myocardial 
      infarction (STEMI), 38 (15.4%) with non-ST elevation myocardial infarction 
      (NSTEMI) and 15 (6.1%) with unstable angina pectoris (UAP), while ACS could be 
      excluded in 165 (66.8%) patients. Patients treated in the CPU showed a higher 
      percentage of ACS with 75 (9.8%) STEMI, 128 (16.7%) NSTEMI and 136 (17.8%) UAP 
      patients; ACS could be excluded in 426 (55.7%) patients. The median length of 
      hospital stay was shorter in ACS patients treated in the CPU at 5.0 days compared 
      to 8.0 days if admitted to the ED (p<0.001). No difference in length of hospital 
      stay was observed in UAP patients, whereas in STEMI patients admitted to the ED 
      the time was longer at 8.0 days compared to 7.0 days if admitted to the CPU 
      (p=0.042). A reduction from 8.0 to 6.0 days in the length of hospital stay if 
      admitted to the CPU compared to the ED could be observed (p=0.002) in NSTEMI 
      patients. CONCLUSIONS: Establishing a chest pain unit with optimized diagnostic 
      and structural processes is associated with reduced lengths of hospital stay in 
      patients with ACS treated according to current guidelines and recommendations.
FAU - Keller, T
AU  - Keller T
AD  - II. Medizinische Klinik und Poliklinik fur Kardiologie, Angiologie und 
      Internistische Intensivmedizin, Universitatsmedizin der 
      Johannes-Gutenberg-Universitat, Mainz, Mainz, Deutschland. T.Keller@uke.de
FAU - Tzikas, S
AU  - Tzikas S
FAU - Scheiba, O
AU  - Scheiba O
FAU - Krahn, U
AU  - Krahn U
FAU - Post, F
AU  - Post F
FAU - Arnolds, S
AU  - Arnolds S
FAU - Blankenberg, S
AU  - Blankenberg S
FAU - Warnholtz, A
AU  - Warnholtz A
FAU - Munzel, T
AU  - Munzel T
FAU - Genth-Zotz, S
AU  - Genth-Zotz S
LA  - ger
PT  - Comparative Study
PT  - Controlled Clinical Trial
PT  - Journal Article
TT  - Reduktion der stationaren Verweildauer bei Patienten mit akutem Koronarsyndrom 
      durch Einrichtung einer Chest Pain Unit.
DEP - 20111105
PL  - Germany
TA  - Herz
JT  - Herz
JID - 7801231
SB  - IM
MH  - Acute Coronary Syndrome/*diagnosis/*epidemiology/therapy
MH  - Coronary Care Units/*statistics & numerical data
MH  - Emergency Service, Hospital/*statistics & numerical data
MH  - Female
MH  - Germany/epidemiology
MH  - Humans
MH  - Length of Stay/*statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Pain Clinics/*statistics & numerical data
MH  - Treatment Outcome
MH  - Utilization Review
EDAT- 2011/11/05 06:00
MHDA- 2012/08/25 06:00
CRDT- 2011/11/05 06:00
PHST- 2011/05/18 00:00 [received]
PHST- 2011/09/29 00:00 [accepted]
PHST- 2011/11/05 06:00 [entrez]
PHST- 2011/11/05 06:00 [pubmed]
PHST- 2012/08/25 06:00 [medline]
AID - 10.1007/s00059-011-3544-2 [doi]
PST - ppublish
SO  - Herz. 2012 May;37(3):301-7. doi: 10.1007/s00059-011-3544-2. Epub 2011 Nov 5.