Accelerated diagnostic protocol linked to psychological benefits and improved quality of life
Gaetano Nucifora, M.D., of the University Hospital S. Maria della Misericordia in Udine, Italy, and colleagues studied 290 patients who had a non-diagnostic electrocardiogram and negative biomarkers. The subjects were randomly assigned to either one of two accelerated diagnostic protocols -- dobutamine-atropine stress echocardiography (DASE) or electrocardiogram exercise testing (EET) -- or usual care, and their quality of life was assessed with the Nottingham Health Profile questionnaire. Compared to the DASE and EET groups, the usual care group reported more impaired mobility and pain before discharge from the hospital, the investigators found. The usual care group also had significantly worse scores for physical mobility, pain, social isolation, emotional reactions and energy levels at the two-month follow-up, the researchers report. "Our study also showed that low-risk patients with acute chest pain experienced psychological benefits using an accelerated diagnostic workup with early DASE or EET that allowed an immediate discharge in case of negative stress test results compared with usual care," the authors write. "The benefit provided by the accelerated diagnostic protocols was already visible at pre-discharge and was maintained during follow-up, although significant improvement in quality of life was observed in all three groups after two months."
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