1683 Clinical impact of a novel ambulatory computed tomography coronary angiography pathway for patients at a moderate risk of suspected acute coronary syndromes

Conclusion We identified 1,341 patients eligible for ambulatory CTCA (524 pre-implementation of pathway; 817 post-implementation; 820 [61%] male; mean age 57 [SD 14]). Pre-implementation, 46.6% (n=244) of these patients were admitted to the Ambulatory Care Unit (ACU). Post-implementation, 32% (n=258) were admitted to the ACU; only 7 (1.3%) eligible patients received ambulatory CTCA after implementation of the service. A further 25 ‘moderate risk’ patients received an inpatient CTCA. The median time to ambulatory CTCA from admission was 1 (IQR 0.75–3) day. Five (71.4%) ambulatory CTCAs were abnormal, identifying coronary artery disease. Three patients with abnormal CTCA underwent PCI; only one followed the ambulatory CTCA pathway. Abstract 1683 Figure 1 Conclusions Clinicians continued to admit patients to inpatient areas, indicating suboptimal utilisation of the pathway. Future work should focus on identifying barriers to adherence.
Source: Emergency Medicine Journal - Category: Emergency Medicine Authors: Tags: RCEM Moderated Papers Source Type: research