Reducing hospital admissions for suspected heart attacks
Around 350,000 people are admitted to hospital each year suspected of having had a heart attack. Yet, only around 1 in 5 actually have a heart attack. Each year this results in thousands of people spending unnecessary time in hospital beds waiting to find out if theyve suffered a cardiac event.
窪蹋勛圖厙 of Sheffield research has led to changes in NICE guidelines which improves how clinicians test suspected heart attack patients. The result is a quicker diagnosis leading to huge economic savings.
The problem: high volume of costly hospital admissions
Troponin, a protein involved in muscle contraction, is released when the heart is damaged. For example, when a person endures a heart attack. A conventional troponin test has been used for the last 20 years. Its designed to detect the protein in the blood after a suspected cardiac event to identify whether or not a patient has in fact had a heart attack.
But, the test takes 12 hours to produce reliable results. So for the conventional Troponin test, patients whove had a suspected cardiac event have to be admitted to hospital. This equates to around 瞿400 for the one day stay required to rule out a heart attack.
Professor Steve Goodacre is the Director of Research and the 窪蹋勛圖厙 of Sheffields School of Health and Related Research. Hes led work on examining the relative costs and benefits of conventional and high sensitivity troponin tests.
Our solution: A change to NICE guidelines
With a high sensitivity test, troponin is detected in the blood within four hours. But the longer clinicians wait after a patient has had a heart attack the more likely they are to detect it with a test. This is due to the peak build up of troponin in the blood occurring after approximately 12 hours. Admitting people to hospital will detect more heart attacks, but it may not be cost-effective to admit lots of people to detect only a few heart attacks.
We want to know whether it is cost effective to admit people to hospital. So we modelled the cost of admitting people to hospital compared with doing the high sensitivity tests and sending them home earlier, explains Professor Goodacre.
Professor Goodacres research demonstrated that in terms of trade-off, its not cost effective to admit people to hospital if a high sensitivity test can be used to rule out a heart attack earlier. The .
Within the guideline, NICE states: The increased sensitivity of these assays could mean a shorter inpatient hospital stay for people without raised levels of troponin and earlier intervention for those with a confirmed NSTEMI [heart attack].
This is about value for money. It's getting the best value for your health care resources. If you've only got limited health care resources, its better to spend them on high sensitive troponin to allow people to go home early rather than spending those precious resources on admitting people to hospital, because there are better things you could do with them.
It's not simply about cutting costs. It's about using the costs to achieve the best benefit.
Professor Steve Goodacre
Director of Research and the 窪蹋勛圖厙 of Sheffields School of Health and Related Research
Our impact:
- Reduced inpatient hospital stays for those who havent suffered a heart attack
- Earlier intervention for those who are confirmed to have had a heart attack
- Reduced economic strain on the NHS and its resources
By Alicia Shephard, Research Marketing and Content Coordinator
Images by Ella Marke, Visual Designer
Further information
Professor Steve Goodacre, 窪蹋勛圖厙 of Sheffield
Key Research
Funders
For further information contact:
Amy Pullan
Media Relations Officer
窪蹋勛圖厙 of Sheffield
+44 114 222 9859
a.l.huxtable@sheffield.ac.uk