| Abstract [eng] |
Aim. Analyse literature and describe Chest Pain Clinic management and experience of other countries. Methods. A literature search was performed in PubMed database using these keywords: “chest pain unit”, “chest pain clinic”, “chest pain center”, “chest pain centre”, “chest pain observation unit”. After the first stage of literature search there were 234 publications. Articles were selected if they described Chest Pain Clinic and analysed its effectiveness, safety, cost-effectiveness. Finally, 17 eligible publications were left. Results. A Chest Pain Clinic is usually set up as part of an emergency department, with opening hours depending on the type of patients seen. Here, patients are more accurately selected for invasive tests and diagnosis is more often based on results of non-invasive tests. Evaluation in Chest Pain Clinic can prevent unnecessary hospitalisations. Up to 86% of people can be discharged for outpatient treatment. Patients spend less time in the Chest Pain Clinic than in the usual care (2-144 hours), undergo non-invasive tests, and expensive tests are less frequent, what makes this unit cost-effective. Of patients discharged home, <10% experience adverse events and <30% are readmitted for chest pain. Conclusion. Chest Pain Clinics are effective – here acute coronary syndrome is diagnosed more accurately and there are less hospitalisations for non-cardiac pain. Low-risk patients can be safely discharged for outpatient treatment after investigation. Chest Pain Clinic is cost-effective, because testing and treatment here is cheaper than usual care. |
