Missed diagnoses of acute cardiac ischemia in the emergency department

Article Abstract:

More research is needed to identify factors that can help emergency room doctors diagnose a heart attack. In a study of 10,689 people who went to an emergency room because they had chest pain, 2% of those who were having a heart attack were mistakenly discharged. Women under the age of 55, people of color, and people with a normal or near-normal electrocardiogram were most likely to be mistakenly discharged. Compared to heart attack patients who were hospitalized, patients mistakenly discharged were twice as likely to die.

Statistical Data Included, Diagnosis, Diagnostic errors, Statistics, Ischemia

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The use of empiric clinical data in the evaluation of practice guidelines for unstable angina

Article Abstract:

Clinical practice guidelines should be based on clinical data and should be tested in an appropriate population before they are published. The Agency for Health Care Policy and Research has published clinical practice guidelines to reduce hospitalization rates for unstable chest pain. Researchers used these guidelines to assign 457 patients presenting with chest pain to one of three categories: low-risk, intermediate risk and high risk. Only 6% were assigned to the low-risk group, indicating that the guideline probably will not reduce hospitalization rates significantly.

Care and treatment, Analysis, Unstable angina, Practice guidelines (Medicine), Cardiac patients

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Patient-specific predictions of outcomes in myocardial infarction for real-time emergency use: a thrombolytic predictive instrument

Article Abstract:

A thrombolytic predictive instrument that takes specific patient characteristics into account can predict whether the patient will benefit from thrombolytic therapy. This is therapy using drugs that break up the blood clots that cause heart attacks. Researchers developed a predictive instrument that calculates 30-day and one-year mortality rates with and without thrombolytic therapy as well as the risk of complications of thrombolytic therapy, including bleeding and hemorrhaging. These are calculated based on specific patient characteristics and can be printed on the electrocardiogram.

Planning, Evaluation, Drug therapy, Thrombolytic therapy, Outcome and process assessment (Health Care), Outcome and process assessment (Medical care)

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