Tzikas S, Keller T, Post F, Blankenberg S, Genth-Zotz S, Münzel T
II. Medizinische Klinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität, 55131 Mainz, Deutschland.
Herz. 2010 Sep;35(6):403-9. doi: 10.1007/s00059-010-3366-7. Epub 2010 Aug 21.
Chest pain units (CPUs) were established primarily in the United States with the aim of reducing hospital admissions and costs, whilst improving quality of life and patient care. Clinical trials have shown that these units are safe and practical; however, there was a need to investigate to what extent patients are satisfied with the care in CPUs. The aim of this study is to evaluate the experiences of patients receiving CPU care and routine emergency department (ED) treatment for acute chest pain.
Patients presenting with acute chest pain at the ED between May 2004 and June 2005 and at the CPU between July 2005 and May 2006 were evaluated in this retrospective analysis. Standardized data collection using all available clinical data as well as telephone follow-up was carried out. Evaluation was carried out on a school-mark basis and a quality assessment was performed.
Of the total population, 479 patients (323 male, 156 female) were treated in the ED, whereas 1176 (743 male, 433 female) in the CPU. In the ED, 26 patients (5.4%) were diagnosed as ST segment elevation myocardial infarction (STEMI), 39 (8.1%) as non-ST segment elevation myocardial infarction (NSTEMI) and 16 (3.3%) as unstable angina pectoris (UAP). In 398 patients (83.1%) acute coronary syndrome (ACS) could be ruled out. In the CPU, the incidence of STEMI was 74 (6.3%), of NSTEMI 141 (12%) and of UAP 153 (13%). ACS was excluded in 808 patients (68.7%). Data on satisfaction with in-hospital treatment was available in 78.5% of cases. In the CPU, 92.2% of the patients judged their treatment as excellent/good, 5.9% as appropriate and 1.9% as poor. The distribution of satisfaction in the ED was significantly lower with 78.6% excellent/good, 18.5% appropriate and 2.9% poor.
The establishment of a CPU at the University Medical Center of Mainz demonstrated a higher level of patient satisfaction compared to the treatment of patients with acute chest pain in the general ED.
胸痛单元（CPU）主要在美国设立，旨在减少住院人数和费用，同时提高生活质量和患者护理水平。临床试验表明这些单元安全且实用；然而，有必要调查患者对胸痛单元护理的满意程度。本研究的目的是评估接受胸痛单元护理和常规急诊科（ED）急性胸痛治疗的患者的体验。
在这项回顾性分析中，对2004年5月至2005年6月在急诊科以及2005年7月至2006年5月在胸痛单元出现急性胸痛的患者进行了评估。使用所有可用临床数据以及电话随访进行标准化数据收集。评估基于学校评分标准进行，并进行了质量评估。
在总人群中，479名患者（323名男性，156名女性）在急诊科接受治疗，而1176名（743名男性，433名女性）在胸痛单元接受治疗。在急诊科，26名患者（5.4%）被诊断为ST段抬高型心肌梗死（STEMI），39名（8.1%）为非ST段抬高型心肌梗死（NSTEMI），16名（3.3%）为不稳定型心绞痛（UAP）。398名患者（83.1%）可排除急性冠状动脉综合征（ACS）。在胸痛单元，STEMI的发生率为74例（6.3%），NSTEMI为141例（12%），UAP为153例（13%）。808名患者（68.7%）排除了ACS。78.5%的病例提供了对住院治疗满意度的数据。在胸痛单元，92.2%的患者认为他们的治疗为优秀/良好，5.9%认为合适，1.9%认为较差。急诊科的满意度分布明显较低，优秀/良好为78.6%，合适为18.5%，较差为2.9%。
与在普通急诊科治疗急性胸痛患者相比，美因茨大学医学中心设立的胸痛单元显示出更高的患者满意度。
