Imperial College London

Academic Institute

Jamil Mayet

Unknown

No

NIBDAPC_2022_0019

Chest pain is one of the most common reasons for presentation to hospital worldwide. However, most patients attending hospital with chest pain are not experiencing a heart attack. Medical professionals need safe and effective ways to identify patients who are not having heart attacks, so that these patients are not admitted to hospital unnecessarily. This could free up beds for other patients who need to come into hospital. ‘Troponin’ is a protein that is released into the bloodstream during a heart attack. Medical professionals can test troponin levels in a patient’s blood to help diagnose - or rule out - heart attack. Troponin tests are one component of the diagnostic pathway for patients coming into the Emergency Department with chest pain. However, different hospitals are using different diagnostic pathways for patients; these pathways vary in terms of the timing of troponin tests and the thresholds that medical professional use to interpret results. At present we do not know which pathway works best to identify patients who are not suffering a heart attack. There may also be differences with regards to the outcomes of patients of different ages, sex, and ethnic groups, who experience chest pain. The aim of this project is to explore differences in chest pain pathways to understand the impacts on patient safety and hospital admission rates, including how patients use the health service after being discharged from the Emergency Department. Collaborating side by side with University Hospitals Birmingham NHS Foundation Trust, Barts Health NHS Trust and University Hospital Southampton NHS Foundation Trust, Imperial College Healthcare NHS Trust’s work is part of a national study proposed by the Health Data Research UK (HDR UK), the UK's national institute for health data science. Each Trust will conduct a local analysis of their data, then the local analyses will be combined at a national level. This work will provide new insights into why patient outcomes vary, enabling initiatives to improve the quality and safety of care delivery for patients presenting to the Emergency Department with chest pain.

This research will lead to benefits for patients attending the Emergency Department in the UK in the future. Our work will inform new ways of working in the Emergency Department to help medical professionals diagnose patients coming in with chest pain. This will mean that patients who are not suffering from a heart attack can be safely allowed to go home instead of having to stay in hospital overnight. In turn, this will free up beds for patients who do need to be admitted to hospital and could reduce the time patients spend in the Emergency Department waiting to be admitted to a ward. For patients with chest pain that is suspicious for heart attack, this work could lead to a reduction in time spent waiting for cardiac investigations or for transfer for specialist treatment.

Public Health Research

13/03/2023

25/11/2022

De-Personalised

Not applicable

Not applicable

One-off

13/03/2023

TRE