A5006531300- Acute Myocardial Infarction Research
- Cardiac Imaging and Diagnostics
- Cardiac Arrest and Resuscitation
- Heart Failure Treatment and Management
- Venous Thromboembolism Diagnosis and Management
- Emergency and Acute Care Studies
- Cardiac, Anesthesia and Surgical Outcomes
- Ultrasound in Clinical Applications
- Traumatic Brain Injury and Neurovascular Disturbances
- Hemodynamic Monitoring and Therapy
- Cardiovascular Function and Risk Factors
- Respiratory Support and Mechanisms
- Sepsis Diagnosis and Treatment
- Cardiac electrophysiology and arrhythmias
- Spinal Fractures and Fixation Techniques
- Poisoning and overdose treatments
- Cardiac Valve Diseases and Treatments
- Central Venous Catheters and Hemodialysis
- Acute Kidney Injury Research
- Trauma and Emergency Care Studies
- Atrial Fibrillation Management and Outcomes
- Trauma Management and Diagnosis
- Renal function and acid-base balance
- Metabolism and Genetic Disorders
- Aortic Disease and Treatment Approaches
Wake Forest University
2016-2025
National Heart Lung and Blood Institute
2023
Beth Israel Deaconess Medical Center
2023
Massachusetts General Hospital
2017-2023
Johns Hopkins University
2023
Harvard University
2017-2023
Intermountain Medical Center
2023
Baystate Medical Center
2010-2023
Cape Fear Valley Health System
2022
Fayetteville VA Medical Center
2022
Admission rates among patients presenting to emergency departments with possible acute coronary syndromes are high, although for most of these patients, the symptoms ultimately found not have a cardiac cause. Coronary computed tomographic angiography (CCTA) has very high negative predictive value detection disease, but its usefulness in determining whether discharge from department is safe well established.
Background— The HEART Pathway is a decision aid designed to identify emergency department patients with acute chest pain for early discharge. No randomized trials have compared the usual care. Methods and Results— Adult symptoms related coronary syndrome without ST-elevation on ECG (n=282) were or In arm, providers used score, validated aid, troponin measures at 0 3 hours Usual care was based American College of Cardiology/American Heart Association guidelines. primary outcome, objective...
Intravenous fluids and vasopressor agents are commonly used in early resuscitation of patients with sepsis, but comparative data for prioritizing their delivery limited.
Background: The HEART Pathway (history, ECG, age, risk factors, and initial troponin) is an accelerated diagnostic protocol designed to identify low-risk emergency department patients with chest pain for early discharge without stress testing or angiography. objective of this study was determine whether implementation the safe (30-day death myocardial infarction rate <1% in patients) effective (reduces 30-day hospitalizations) possible acute coronary syndrome. Methods: A prospective...
Background: Patients with low-risk chest pain have high utilization of stress testing and cardiac imaging, but low rates acute coronary syndrome (ACS). The objective this study was to determine whether the HEART score could safely reduce in patients pain. Methods: A cohort identified from an emergency department-based observation unit registry. scores were determined using registry data elements blinded chart review. dichotomized into (0–3) or risk (>3). outcome major adverse events (MACE);...
Abstract Introduction The History, Electrocardiogram (ECG), Age, Risk Factors, and Troponin (HEART) score is a decision aid designed to risk stratify emergency department (ED) patients with acute chest pain. It has been validated for ED use, but it yet be evaluated in prehospital setting. Hypothesis A modified HEART can predict major adverse cardiac events (MACE) among undifferentiated pain transported the ED. Methods retrospective cohort study of by two county-based Emergency Medical...
Objective: Use of point-of-care (POC) troponin (cTn) testing in the Emergency Department (ED) is well established. However, data examining POC cTn measurement prehospital setting, during ambulance transport, are limited. The objective this study was to prospectively test performance by paramedics detect myocardial infarction (MI) among patients transported ED for acute chest pain. Methods: A prospective cohort adults with non-traumatic pain conducted three Medical Services agencies (December...
B-type natriuretic peptide is useful to diagnose heart failure. We determined whether the use of serial measurements guide treatment improves outcome in patients with acute failure.We conducted a randomized controlled trial failure 10 academic and community emergency departments. The experimental group received testing (at 3, 6, 9, 12 hours then daily). control usual care. Our outcomes were hospital length stay, 30-day readmission rate, all-cause mortality. There 219 controls 228 patients....
The aim of this study was to determine the effect stress cardiac magnetic resonance (CMR) imaging in an observation unit (OU) on revascularization, hospital readmission, and recurrent testing intermediate-risk patients with possible acute coronary syndromes (ACS). Intermediate-risk commonly undergo admission high rates revascularization. It is unknown whether OU-based care CMR a more efficient alternative. A total 105 participants symptoms ACS but without definite basis first...
Sepsis ranks among the "Big Three" conditions most prone to harmful diagnostic errors. Despite its high prevalence and severity, health systems lack effective contextually tailored strategies optimize accuracy for sepsis. The purpose of this study is understand factors related sepsis using principles tools safety implementation science. This a multi-site involving 20 hospitals across four states in United States. primary objectives are (1) describe hospital-level variability barriers...