Improving Emergency Department Referrals for Chest Pain: URGENT 2.0 Trial
Overview
Ischaemic heart disease is the leading cause of death globally. Identifying patients with serious heart issues during prehospital care for chest pain is often difficult for doctors and paramedics. Less than 20% of chest pain patients sent to the emergency department (ED) actually have acute coronary syndrome (ACS), which leads to high healthcare costs and unnecessary patient stress. Better risk assessment using cardiac troponin tests can significantly improve diagnosis before patients reach the hospital.
Trial Details
The URGENT 2.0 trial aims to reduce the number of patients with non-cardiac chest pain (NCCP) sent to the ED. This will be done using a modified HEART score along with a sensitive cardiac troponin test. Ambulance paramedics will enroll patients and randomly assign them to one of two groups:
- Control Group: Regular care
- Intervention Group: Modified HEART score analysis and non-referral for low scores (0-3)
A total of 852 patients will participate, with follow-up assessments at 30 days, 6 months, and 12 months. The main goals are to track the referral rates of NCCP patients and any serious heart-related events.
Ethics and Publication
This trial has received ethics approval from the Zuyderland-Zuyd Hogeschool committee in the Netherlands. All participants will give written consent. The findings will be shared in a main paper and additional reports analyzing specific groups.
Trial Registration
Registered at ClinicalTrials.gov, NCT04904107.
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