BNP Measurement Reduces Resource Utilization for Patients With CHF Admitted Thorough the ED
Study Details
Study Description
Brief Summary
Measurement of brain natriuretic peptide (BNP) in dyspneic patients increases diagnostic accuracy for congestive heart failure (CHF). Limited information is available regarding economic outcomes attributable to BNP assay. The aim of this study was to assess the economic impact of BNP assay in elderly dyspneic patients presenting to the emergency department (ED).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
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Detailed Description
Dyspneic patients 65 years were enrolled in a randomized, controlled trial; hemodynamically unstable patients were excluded. BNP (Biosite assay) levels were measured prior to physician assessment with randomization in 1:1 ratio to either BNP 1) level reported or 2) level not reported. ED physicians made triage decisions guided by clinical judgment and nomogram to aid in interpretation of BNP level. Primary outcome was mean total hospital cost per subject. Secondary outcomes included admission rate, service assignment, discharge diagnosis and length of stay. Differences between groups were compared by t-test with bootstrap. Costs reflect 2005 constant dollars.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| A BNP level from protocol blood tests initiated in the ED, reported to ED physician prior to ED disposition. |
|
| B BNP level from protocol blood tests initiated in the ED, NOT reported to ED physician prior to ED disposition. |
Outcome Measures
Primary Outcome Measures
- Mean total hospital cost per subject [spans from ED eval through hospitalization discharge]
Secondary Outcome Measures
- Included admission rate, service assignment, discharge diagnosis, and length of stay. [from ED evaluation through hospitalization discharge]
Eligibility Criteria
Criteria
Inclusion Criteria:
- Dyspneic patients 65 years or older presenting to the ED with chief complaint of shortness of breath.
Exclusion Criteria:
- hemodynamically unstability
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Saint Marys Hospital, Mayo Clinic | Rochester | Minnesota | United States | 55905 |
Sponsors and Collaborators
- Mayo Clinic
Investigators
- Principal Investigator: Raquel M Schears, MD, MPH, Mayo Clinic
- Principal Investigator: Alfredo L Clavell, MD, Mayo Clinic
- Study Chair: Lyle J Olsen, MD, Mayo Clinic
- Study Director: Paula J Santrach, MD, Mayo Clinic
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
- Clavell AL, Stingo AJ, Aarhus LL, Burnett JC Jr. Biological actions of brain natriuretic peptide in thoracic inferior vena caval constriction. Am J Physiol. 1993 Dec;265(6 Pt 2):R1416-22.
- Schmidt TA, Salo D, Hughes JA, Abbott JT, Geiderman JM, Johnson CX, McClure KB, McKay MP, Razzak JA, Schears RM, Solomon RC; SAEM Ethics Committee. Confronting the ethical challenges to informed consent in emergency medicine research. Acad Emerg Med. 2004 Oct;11(10):1082-9. Review.
- 1780-03