Triage and Diagnosis of Chest Pain in Rural Hospitals: Implementation of the ACI-TIPI in the High Plains Research Network
Ann Fam Med Westfall et al.
4: 153
The Article in Brief
Background Ischemia, a condition in which the heart does not receive enough blood, and a possible cause of heart attack, can be difficult to diagnose. The Acute Cardiac Ischemia Time-Insensitive Predictive Instrument (ACI-TIPI) is designed to help diagnose acute ischemia in patients with chest pain and to help clinicians decide whether a hospital admission is needed by printing the patient's probability of acute cardiac ischemia on their electrocardiogram. The ACI-TIPI has been tested in urban and suburban settings. This study tested the impact of ACI-TIPI in rural emergency departments.
What This Study Found Among patients with chest pain at emergency departments in 10 rural hospitals, the use of ACI-TIPI did not have a significant impact on accuracy of diagnosis or triage (that is, decisions by emergency department staff to admit, transfer or discharge the patient).The average diagnostic accuracy was similar regardless of whether ACI-TIPI was used (86.8% ACI-TIPI off vs 89.0% ACI-TIPI on).
Implications
- Rural doctors in this study provided appropriate diagnosis and triage of patients with chest pain.
- Conducting this type of study in more rural hospitals may provide a broader base of information on the effect of ACI-TIPI in rural settings.
