Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
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Original Article

Volume 8, Number 2, February 2016, pages 111-115

Impact of Chest Pain Protocol Targeting Intermediate Cardiac Risk Patients in an Observation Unit of an Academic Tertiary Care Center


Figure 1.
Figure 1. Protocol algorithm.
Figure 2.
Figure 2. Protocol and non-protocol LOS.
Figure 3.
Figure 3. Protocol and non-protocol mean CPD with outliers excluded. Note: five patients were removed from the protocol group due to outliers costs (CTPE) and four subjects in the non-protocol group did not have cost data available. Therefore, the sample sizes for this analysis were 10 for the protocol group and 11 for the non-protocol group.
Figure 4.
Figure 4. Protocol and non-protocol mean CPD with original data.


Table 1. Inclusion Criteria
Inclusion criteria
Chest pain
Normal baseline EKG
Negative cardiac enzymes
Atypical angina Sx
< 3 cardiac risk factors


Table 2. Exclusion Criteria
Exclusion criteria
TIMI risk ≥ 5
Continued or unrelieved CP
New transient ST deviation on EKG
New TWI in precordial leads of EKG
Hemodynamic instability
Altered mental status
Elevated cardiac enzymes
Individuals who are not yet adults


Table 3. Patient Demographics for Total Sample
Total sample (n = 30)Non-protocol (n = 15)Protocol (n = 15)P
Values represent N (%) unless otherwise indicated. *Between-group analysis was not performed for this variable because having a stress test was part of the intervention in the protocol group.
Gender (female)17 (56.7)10 (66.7)7 (46.7%)0.27
Current smoker (yes)14 (46.7)8 (53.3)6 (40.0)0.46
Hypertension (yes)19 (63.3)12 (80)7 (46.7%)0.13
Hyperlipidemia (yes)14 (46.7)7 (46.7%)7 (46.7%)1.0
Diabetes (yes)8 (26.7)7 (46.7%)1 (6.7%)0.04
Stress test performed (yes)26 (86.7)11(73.3)15 (100)0.10
Negative stress test (if stress test performed)*25 (96.2)
Age, mean (SD)56.6 (10.3)60.3 (9.80)52.9 (9.70)0.05