Cardiac Ultrasound Identifies Low-Risk Patients

Myocardial contrast echocardiography may decrease admissions in chest pain patients

THURSDAY, Sept. 18 (HealthDay News) -- Despite the cost of performing myocardial contrast echocardiography (MCE) in all patients with suspected cardiac chest pain and a non-diagnostic electrocardiogram (ECG), MCE can identify low-risk patients with non-cardiac chest pain that can safely be discharged and potentially reduce unnecessary hospitalizations and costs, according to the results of a study published in the Sept. 15 issue of the American Journal of Cardiology.

Jared J. Wyrick, M.D., of the Oregon Health & Science University in Portland, and colleagues evaluated the cost effectiveness of MCE to detect non-cardiac chest pain among 957 patients presenting to the emergency department with suspected cardiac chest pain and a non-diagnostic ECG. Costs were calculated using national average Medicare charges adjusted by a cost-charge ratio.

Based on routine clinical practice, 641 patients (67 percent) were admitted to the hospital and 316 (33 percent) were discharged directly from the emergency department with an average evaluation cost of $5,000, the researchers report. Among the 523 patients with normal MCE results, the primary event rate (death or acute myocardial infarction) was 0.6 percent within 24 hours after presentation. Utilizing MCE for decision-making would have resulted in 523 patients (55 percent) being discharged directly from the emergency department and 434 (45 percent) admissions, the report indicates. Preventing unnecessary admissions and the resulting tests would decrease the emergency department stay and save an average of $900 per patient.

"In conclusion, by excluding cardiac causes in patients presenting to the emergency department with chest pain and a non-diagnostic ECG, MCE can prevent unnecessary admissions and downstream resource utilization, making it a cost-efficient tool in the evaluation of these patients," the authors report.

This study was supported, in part, by a grant from GE Healthcare.

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