Outcome analysis of chest pain patients discharged from the ED - A pilot study

The objective of this pilot study was to determine clinical predictors of a dverse outcome, defined as myocardial infarction, angioplasy or stent place ment, coronary artery bypass graft, or death, within 60 days for patients d ischarged from the emergency department with a presenting complaint of ches t pain. All patients presenting to the emergency department with a chief co mplaint of chest pain were eligible for the study. A chest pain risk analys is sheet was completed as part of the patient evaluation. Patients discharg ed from the emergency department, in whom a risk analysis sheet was complet ed, were contacted to determine their clinical course within 60 days of the ir discharge from the emergency department. During the 6-month study period , 129 eligible patients were enrolled. Of these 129 patients, four had an a dverse outcome within 60 days of their discharge. All four patients had eit her a balloon angioplasty procedure, coronary artery bypass graft, or both, None of the study patients had a myocardial infarction or died, Statistica lly significant predictors of adverse outcome in our study population were an abnormal electrocardiogram (ECG), a history of myocardial infarction, an d a history of hypertension. In conclusion, patients discharged from the em ergency department with a presenting complaint of chest pain were at a low risk for having a myocardial infarction or dying within 60 days of their di scharge. Several patients, however, did have significant coronary artery di sease requiring angioplasty or bypass. These patients were more likely to h ave an abnormal EGG, a history of myocardial infarction, or have a history of hypertension. A prospective study with larger numbers of patients is nee ded to validate these findings. Copyright (C) 2000 by W.B. Saunders Company .