Endocrine Abstracts

Background

Accurate identification of patients at risk in the Emergency Department (ED) is crucial in order to avoid delays in treatment which may result in poor outcomes. Our aim was to study the association of the decision in ED to admit patients with chest pain and/or breathlessness in the ED to a ward with risk stratification by RETTS or NEWS and level of the surrogate biomarkers Copeptin, MR-proADM and MR-proANP of vasoregulatory hormones.

Methods

Patients presenting at the ED with chest pain and/or breathlessness were enrolled. Vital signs were recorded and patients were triaged accordingly to Rapid Emergency Triage and Treatment System (RETTS). NEWS (national early warnings score) was retrospectively calculated from the vital signs. Levels of Copeptin, MR-proADM and MR-proANP on presentation were analyzed.

Results

334 patients were included. The median age was 64 year. 167 (50%) of them were male. 210 (63%) patients complained of chest pain, 65 (20%) of breathlessness and 59 (18%) of chest pain and breathlessness. Of those 176 (52.7%) patients were admitted to a ward and 158 (47.3%) patients were discharged from ED. In binary logistic models age, gender, vital parameters, NEWS class and Copeptin were associated with admission to award from ED, whereas there was no association with RETTS, MR-proADM or MR-proANP. Assessed by receiver operating characteristic (ROC) curves constructed with: age, gender and vital signs for prediction of admission from ED, addition of copeptin did not significantly increase the area under the curve (AUC).

Conclusions

Age, vital signs, NEWS and copeptin, are related to the decision of admission to a ward from ED for patients with chest pain and/or breathlessness.