No registrations found.
ID
Source
Brief title
Health condition
Acute coronary syndrome
Non-st segment Elevated Myocardial Infarction
Undifferentiated chest pain
Sponsors and support
Intervention
Outcome measures
Primary outcome
Unexpected Serious Adverse Events (USAE) at 3 and 30 days from the index contact.
Secondary outcome
* USAE at 6 months and 1 year from the index contact
* Unexpected Major Adverse Cardiac Event (UMACE) at 3 days, 30 days, 6 months and 1 year after index contact.
* Cumulative healthcare-related costs/resource
* Quality of life at 3 days, 30 days, 6 months and 1 year of the index contact evaluated through the EuroQol 5D-5D-5L
Background summary
Decisions on (non-)conveyance of patients are challenging for the ambulance personnel (emergency medical services [EMS]). The majority (>75%) of patients presenting with undifferentiated chest pain (or discomfort) is conveyed to the nearest hospital. Improving pre-hospital assessment of patients with undifferentiated chest pain may improve safety, optimize the efficacy of care, and reduce health-related costs.
Observational data in patients conveyed to the hospital suggests that our recently developed pre-hospital HEART (preHEART) risk score represents a reliable tool to identify individuals at very low risk (±38% of patients), low-intermediate (±5%) and very high risk (±7%) of severe cardiovascular pathology requiring urgent care. Whether adding this decision support tool in clinical practice to support the decision-making process on (non-)conveyance by the ambulance personnel is safe and more.
Study objective
The PreHEART score supports EMS staff in their decision to convey a patient with undifferentiated chest pain and increases the non-conveyance up to 20%, which leads to fewer presentations to an ED.
Study design
3 days, 3 and 12 month
Intervention
The PreHEART is available to a randomized patient whose risk of an ACS has been assessed. The decision to convey can be guided by the preHEART score which suggestion to non-convey for patients with a very low risk of ACS, or convey patients with intermediate risk to the nearest hospital, or convey a patient to a hospital with PCI facilities.
Inclusion criteria
Adults with undifferentiated chest pain.
Exclusion criteria
Communication barrier (e.g. language, understanding)
ST-segment elevation (electrocardiogram on scene is standard workup)
Any obvious etiology for the symptoms requiring direct treatment (e.g. trauma)
Being previously evaluated by ambulance personnel for the same complaint (already considered for participation)
High clinical suspicion of a life-threating condition (e.g. sudden death survivor, hypothermia, shock, aortic dissection, hypoxia or intoxication)
Cognitive impairment
End-stage renal disease
Pregnancy
Inability or unwillingness to provide informed consent
Not registered with a GP (huisarts)
COVID suspicion
Design
Recruitment
IPD sharing statement
Plan description
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL7866 |
| Other | METC UMCG : METC approval pending |