In-Hospital Cost Comparison of Triple-Rule-Out Computed Tomography Angiography Versus Standard of Care in Patients With Acute Chest Pain.
Acute Pain
/ cerebrospinal fluid
Adolescent
Adult
Aged
Aged, 80 and over
Chest Pain
/ diagnostic imaging
Computed Tomography Angiography
/ economics
Coronary Angiography
/ economics
Coronary Artery Disease
/ complications
Costs and Cost Analysis
/ economics
Female
Humans
Male
Middle Aged
Retrospective Studies
Standard of Care
/ economics
Young Adult
Journal
Journal of thoracic imaging
ISSN: 1536-0237
Titre abrégé: J Thorac Imaging
Pays: United States
ID NLM: 8606160
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
pubmed:
8
2
2020
medline:
4
2
2021
entrez:
8
2
2020
Statut:
ppublish
Résumé
The purpose of this study was to evaluate the utilization of invasive and noninvasive tests and compare cost in patients presenting with chest pain to the emergency department (ED) who underwent either triple-rule-out computed tomography angiography (TRO-CTA) or standard of care. We performed a retrospective single-center analysis of 2156 ED patients who presented with acute chest pain with a negative initial troponin and electrocardiogram for myocardial injury. Patient cohorts matched by patient characteristics who had undergone TRO-CTA as a primary imaging test (n=1139) or standard of care without initial CTA imaging (n=1017) were included in the study. ED visits, utilization of tests, and costs during the initial episode of hospital care were compared. No significant differences in the diagnosis of coronary artery disease, pulmonary embolism, or aortic dissection were observed. Median ED waiting time (4.5 vs. 7.0 h, P<0.001), median total length of hospital stay (5.0 vs. 32.0 h, P<0.001), hospital admission rate (12.6% vs. 54.2%, P<0.001), and ED return rate to our hospital within 30 days (3.5% vs. 14.6%, P<0.001) were significantly lower in the TRO-CTA group. Moreover, reduced rates of additional testing and invasive coronary angiography (4.9% vs. 22.7%, P<0.001), and ultimately lower total cost per patient (11,783$ vs. 19,073$, P<0.001) were observed in the TRO-CTA group. TRO-CTA as an initial imaging test in ED patients presenting with acute chest pain was associated with shorter ED and hospital length of stay, fewer return visits within 30 days, and ultimately lower ED and hospitalization costs.
Identifiants
pubmed: 32032251
doi: 10.1097/RTI.0000000000000474
pii: 00005382-202005000-00009
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
198-203Références
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