Which “ROMI” Patients Can Be Sent Home After Two Hours?

Discharge was safe for patients age <50 years with <3 risk factors for coronary artery disease and no prior CAD or myocardial infarction.

Several attempts have been made to develop decision aids for chest pain patients (NEJM JW Emerg Med Sep 2012 and Acad Emerg Med 2012; 19:837; NEJM JW Emerg Med Aug 2012 and J Am Coll Cardiol 2012; 59:2091). In a secondary analysis of data from two prior studies in Australia and New Zealand, researchers sought to determine a set of characteristics to identify patients who could safely be discharged without further troponin or stress testing.

Among 2396 patients with chest pain who had nonischemic electrocardiogram findings and negative conventional troponin results 2 hours after presentation, 5.3% had a diagnosis of acute coronary syndrome (ACS) within 30 days. The authors used regression analyses to identify predictors of low risk for ACS. A…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Which “ROMI” Patients Can Be Sent Home After Two Hours?

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Reviewing Author