Chest pain observation units reduce hospital admission in people with acute chest pain

Abstract

Question

For people presenting with acute chest pain, how effective and cost-effective is care in a chest pain observation unit compared with routine care?

Study design

Cluster randomised controlled trial.

Main results

Hospital admissions were significantly less likely with the chest pain observation unit (CPOU) compared with routine care (36.7% CPOU vs 53.8% routine care; adjusted OR 0.49, 95% CI 0.36 to 0.65). There was no significant difference between groups in the incidence of major coronary events at 6 months (3.8% with CPOU vs 3.4% with routine care; difference 0.4%, 95% CI –2.0% to +2.7%). The mean cost of chest pain related care per participant was lower for the CPOU than for routine care, but the difference was not significant (£478 for CPOU vs £556 for routine care; adjusted difference £53, 95% CI −£88 to +£194).

Authors’ conclusions

Care in a chest pain observation unit reduces hospital admissions and may be more cost effective than routine care.