For immediate release --
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VANCOUVER (October 19th, 2005) - A team led by a Providence Health Care (PHC) researcher has developed a test for identifying the severity of chest pains that may help reduce emergency department overcrowding.
The Vancouver Chest Pain Rule helps determine which chest pain patients can be safely sent home sooner. It involves a brief examination performed on ER patients that tests for specific symptoms. If chest pain patients have a normal cardiogram and negative laboratory tests, the patient is considered at low risk for complications and can be safely discharged without prolonged emergency room observation, extensive rule-out protocols or expensive testing.
This finding, appearing in an early online release from Annals of Emergency Medicine (A Clinical Prediction Rule for Early Discharge of Patients with Chest Pain), is critical in the fight to relieve emergency department overcrowding, improve cost-effectiveness of certain coronary diagnostic testing and reduce patient inconvenience.
"Patients who go to the emergency department with chest pain fall into three categories: those who do indeed have serious symptoms and need admission and treatment, those whose pain is not related to heart problems, and those who require testing and diagnosis to rule out acute or life-threatening conditions," explains lead study author Dr. James Christenson, Research Director, St. Paul's Hospital Department of Emergency Medicine.
The Vancouver Chest Pain Rule uses age, initial history, tests designed to diagnose heart disease, and pain characteristics to identify 32.5 per cent of patients who complain of chest pain but do not have an acute heart condition, said Christenson. These very low-risk patients are identified with minimal error using the Vancouver Rule.
High-risk patients are also better identified and served accordingly. The Vancouver Rule reduced the number of patients who had undetected acute cardiac conditions and were discharged from 5 percent to only 1 per cent.
With Canadian emergency visits rising to over 5.1 million in 1999, up from 4.1 million in 1993 and 3.4 million in 1990, the majority of the nation's hospital ER departments report that they are operating "at" or "over" critical capacity. Experts predict that these figures will climb with overall increases in population growth, as well as an increasing elderly population with more severe chronic illness. "We believe that if broadly implemented, our clinical prediction rule could help relieve some of the overcrowding currently plaguing emergency departments," says Dr. Christenson.
"Advances in diagnostic testing in the emergency room have the potential to benefit the thousands of Canadians who experience chest discomfort and must visit a hospital," said Dr. Bruce McManus, Scientific Director, Institute of Circulatory and Respiratory Health, CIHR and Principal Investigator for the iCAPTURE Centre at St. Paul's Hospital. "We're committed, with our partners, to funding the kind of research that will improve the health care system. This new work is a significant step forward for patients and health professionals".
Annals of Emergency Medicine is the peer-reviewed journal of the American College of Emergency Physicians, a national organization with 23,000 members. The article will be available online October 19, 2005 at http://www.mosby.com/annemergmed.
This study was funded by the Canadian Institutes of Health Research (CIHR) and the Heart and Stroke Foundation of B.C. and Yukon.
The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health care system. Composed of 13 Institutes, CIHR provides leadership and support to close to 10,000 health researchers and trainees across Canada. http://www.cihr-irsc.gc.ca/
St. Paul's Hospital is part of Providence Health Care, Canada's largest faith-based health care organization based in Vancouver, British Columbia.
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For more information please contact:
Justin Karasick Providence Health Care, CommunicationsTel.: 604-806-8022 or 604-667-4397.(media pager)E-mail: jkarasick@providencehealth.bc.ca
Marie-France PoirierCIHR Media Relations, Media SpecialistTel.: 613-941-4563E-mail: mediarelations@cihr-irsc.gc.ca
