The person you need to talk to is Zul Mirza at West Middlesex U H. He is
using a protocol for point of care multimarker testing and has a series of
6,000 patients with brilliant results for accuracy in deciding who can
safely go home and who needs further investigation. I have to say that I
believe 12 hour troponins and hospitalization, even in obs wards are not
necessary for most patients. Zul is sending 70% of his patients home after
a two hour protocol and has a morbidity of about 0.1% in discharged
patients. You could also have a look at a study I was involved in,
published in the European Journal in January, using a protocol from which
Zul's was developed.
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of sri srinivas
Sent: 16 July 2008 15:13
To: Laurence Rocke
we are attempting to reduce admissions for chest pain ?ACS and use the obs
ward in a/e for them to do the 12 hour trop and decide on further tests like
stress test etc.
Does anybody have sensible guidelines or risk stratifying score to pick the
low risks for obs ward. is anybody using TIMI scores to do this?
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