Rapid diagnosis for patients with cardiac symptoms

Since 2008, EMF has invested more than $1 million in acute cardiac research projects led by Royal Brisbane and Women’s Hospital (RBWH) Emergency physician, Adjunct Professor Louise Cullen.

Chest pain is the second most common complaint among patients presenting to emergency departments. However, only 15 per cent of these patients are actually suffering from acute coronary syndrome.

According to Professor Louise Cullen, these patients may undergo lengthy, intensive and costly assessments, which had traditionally taken between 12 and 24 hours.

“There has been little difference in assessment strategies and costs for the low and intermediate risk patients, resulting in the majority of patients experiencing prolonged hospital stays,” Professor Cullen said.

To address this issue, Professor Cullen and her research team initially developed the ADAPT Protocol, which enables clinicians to accelerate the assessment of about 20 per cent of cardiac patients.

With funding from Queensland Health, the protocol was rolled out to 19 Queensland Hospitals between 2013 and 2015 as the Accelerated Chest Pain Risk Evaluation (ACRE) project. The project is estimated to be delivering $11.2 million annually in economic benefits to the State’s healthcare system (although a QUT study put the figure at $21 million).

In 2016, the National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand updated their Guidelines for the Management of Acute Coronary Syndromes (ACS), to incorporate the ADAPT protocol.

Professor Cullen’s team has since developed a second protocol known as the Improved Assessment of Chest Pain (ImpACT) protocol, which can safely accelerate the assessment of up to 70 per cent of emergency patients presenting with chest pain. Using this newer protocol, emergency physicians can identify low risk patients not at risk of heart disease within two hours of arrival in the emergency department and discharge them without needing ongoing testing, and more rapidly assess other patients at higher risk for heart disease.

In 2016, Queensland Health awarded the team an $800,000 grant to pilot ImpACT at the Cairns Hospital and potentially roll it out to further Queensland Hospitals.

It has been estimated that this newer protocol could deliver additional economic benefits of $12.4 million annually if rolled out in all Queensland hospitals.

Key researchers: Professor Louise Cullen and Dr Will Parsonage

Read more about the ImpACT research:

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