Cardiac CT Shown More Cost-Effective Managing Low-Risk Patients with Chest Pain in the Emergency Department

The use of cardiac computed tomography (CT) imaging for low-risk chest pain patients in the emergency department, instead of the conventional standard of care (SOC) workup, may reduce a patient's length of stay and hospital charges, according to a new study. The SOC workup, which is time-consuming and expensive, consists of a series of cardiac enzyme tests, electrocardiograms (ECGs), and nuclear stress testing.

The study was performed by investigators from the University of Washington School of Medicine (Seattle, WA, USA). Fifty patients were included. "We found that cardiac CT-based workups in low-risk chest pain patients decreased the length of hospital stay up to 20 hours and was significantly les expensive [44% less] than using the standard of care workup,” said Janet May, MS, lead author of the study. "The SOC mean length of stay was 25.4 hours and the mean length of stay for cardiac CT with observation was 14.3 hours. The mean charges for SOC were [US]$7,597; the mean charges for cardiac CT with observation were $6,153; and the mean charges for cardiac CT without observation were $4,251.”

The study was published in the July 2009 issue of the American Journal of Roentgenology (AJR). "Delivering care through emergency departments is expensive, so cost containment in that setting is critical. Over six million patients present to US emergency rooms each year with chest pain and up to 79% of those patients fall into the low-risk category. Our study shows that cardiac CT has the potential to significantly reduce cost and length of stay in the emergency department by rapidly identifying those patients who can safely be discharged quickly,” concluded Ms. May.

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University of Washington School of Medicine