ArticleClinical cardiology2014
One-year outcomes associated with using observation services in triaging patients with nonspecific chest pain.
Article in Clinical cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 8 citations in OpenAlex.
- Chest pain triage: Current trends in the emergency departments in the United States.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Review
- Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.BMJ (Clinical research ed.) · 2017Article
- Variability in the initial costs of care and one-year outcomes of observation services.The western journal of emergency medicine · 2015Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObservation services are provided in greatly variant settings. The aim of this study was to reexamine the effectiveness of observation services compared to inpatient units for patients with nonspecific chest pain. HYPOTHESIS: Patients admitted to observation units have similar outcomes to patients admitted to inpatient wards.
methodsWe conducted a claim-based retrospective study for 7549 patients who were admitted to observation and inpatient units. Both models of care were evaluated using the 1-year costs related to chest pain/cardiovascular diseases, and primary and secondary outcomes. Primary outcome was a composite of myocardial infarction, congestive heart failure, stroke, or cardiac arrest, whereas secondary outcomes included revascularization procedures, emergency room revisits, and hospitalization due to cardiovascular diseases.
resultsTwo-thirds (65.7%, n = 4962) of patients in the sample had observation services, and 34.3% (n = 2587) were admitted to inpatient care. Of the inpatient group, 4.9% experienced a total of 167 primary outcomes, whereas 14.1% experienced a total of 571 secondary outcomes. In comparison, 3.8% of the observation group experienced 238 primary outcomes, and 10.3% experienced 737 secondary outcomes. After adjusting for baseline characteristics using Cox proportional hazard and quantile regression models, no differences between the 2 groups were detected in the 1-year costs of cardiovascular services and primary or secondary outcomes. Patients who had observation services were 79% (95% confidence interval: 1.24-2.58) more likely to have revascularization procedures compared to those admitted to inpatient care.
conclusionsPatients who had observation services had similar outcomes and 1-year costs compared to patients admitted to inpatient wards.
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