This writes the Volkskrant. It is expected that this new procedure will save tens of millions of euros per year in costs and will save a lot of hassle for the patient and pressure on the emergency department.
Cardiologist Cyril Camaro, together with fellow scientists from Radboudumc in Nijmegen, researched a new way of working and is publishing an article in the European Heart Journal with their positive discoveries.
Often little going on
In the Netherlands, 200,000 patients with chest pain report annually to the Eerste Harthulp, the emergency department for people with possible heart conditions.
The protocols of GPs and ambulance staff, for example, are fine-tuned: chest pain can indicate a heart attack, a life-threatening condition that requires urgent action. In the hospital, however, it appears that little is wrong with 80 to 90 percent of the patients.
But these patients all end up in the hospital at the moment, taking up time, space and money. Reason enough to investigate whether there is no other way.
Avoid hospital visits
The new procedure proposes to determine whether it is necessary to move the patient prior to the hospital visit. When paramedics arrive at a patient with chest pain, they must first determine whether the risk of a heart attack is high or low.
Someone with a high risk still goes straight to the hospital, but with someone with a low risk, the paramedics measure the troponin level in the blood – an action that was previously only possible in the hospital, but is now also possible on the road or in the ambulance can be performed.
The amount of troponin, a protein released during heart damage, indicates the severity of the situation. Patients with a low amount of troponin can then stay at home.
The study involved 863 low-risk patients, half of whom went to the hospital via the old method, and the other half stayed at home. The risk of serious heart disease in the month after the chest pain symptoms appeared to be negligibly small in both groups.
In the first 30 days, two patients in the stay-at-home group still developed heart complaints that required a hospital visit (0.5 percent); in the hospital group there were four patients (1 percent); statistically no difference.
Safe way of working
This discovery has major consequences, Camaro told de Volkskrant. “We show that this way of working is safe for the patient, and also much more pleasant. In an ambulance and at the heart aid, you come into contact with all kinds of bells and whistles. People often cannot work for one or two days. ended up in a hospital, an intense experience.'”
The cardiologist expects that the treatment on site can lead to a significant reduction in emergency departments. They now regularly have to close their doors to new patients because there is no longer a bed available.
“At a conservative estimate, this way of working saves one in four heart aid admissions, which is 50,000 patients per year.” If this way of working were to be introduced throughout the Netherlands, the cost savings would be 48 million euros, Camaro calculates.
Other cardiologists are also enthusiastic about the results of the study. For example, Rudolf de Boer, head of cardiology at Erasmus MC, vice-chairman of the Dutch Cardiology Association, and not involved in the study, speaks of ‘good news’ and a ‘fantastic study.
“This can save enormous numbers of patients in hospitals. We must start working in this way nationwide as soon as possible. Dutch cardiology will take this up.”
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