Cost and Resource Utilization Associated With Use of Computed Tomography to Evaluate Chest Pain in the Emergency Department The Rule Out Myocardial Infarction Using Computer Assisted Tomography (ROMICAT) Study

摘要: Background— Coronary computed tomographic angiography (cCTA) allows rapid, noninvasive exclusion of obstructive coronary artery disease (CAD). However, concern exists whether implementation cCTA in the assessment patients presenting to emergency department with acute chest pain will lead increased downstream testing and costs compared alternative strategies. Our aim was compare observed actual usual care (UC) projected a strategy including early evaluation Rule Out Myocardial Infarction Using Computer Assisted Tomography I (ROMICAT I) study. Methods Results— We cost hospital length stay UC among 368 enrolled ROMICAT study management based on cCTA. Costs were determined by an electronic accounting system. Notably, not influenced results because caregivers blinded results. after estimated assuming changes findings presence severity CAD. Sensitivity analysis used test influence key variables both outcomes costs. that comparison UC, cCTA-guided triage, whereby no CAD are discharged, could reduce total 23% ( P 28% 33%, use becomes more costly than UC. Conclusions— may be cost-saving tool populations have prevalence potentially <30%. would anticipated higher disease. Clinical Trial Registration— URL: . Unique identifier: [NCT00990262][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT00990262&atom=%2Fcirccvoq%2Fearly%2F2013%2F09%2F10%2FCIRCOUTCOMES.113.000244.atom