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We compared the National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand (NHF/CSANZ) guideline and the Thrombolysis in Myocardial Infarction (TIMI) risk score for differentiating high- and low-risk patients. Composite outcome was all cause death, myocardial infarction or coronary revascularisation within 30 days. Results: Of 1758 enrolments, 223 (13%) reached the study outcome. Area under the receiver operator characteristic (ROC) curve was 0.79 (95% CI 0.76�C0.81) for the NHF/CSANZ group and 0.71 (0.68�C0.75) for TIMI score based on initial troponin result (P?<?0.001), and 0.82 (95% CI 0.80�C0.84) and 0.76 (0.73�C0.79) respectively when the <a href="http://www.selleckchem.com/products/DAPT-GSI-IX.html">DAPT 8�C12?h troponin result is included (P?=?0.001). Thirty day event rates were 33% for NHF/CSANZ high-risk vs 1.5% for combined low/intermediate risk (P?<?0.001). For TIMI score, 30 day event rates were 23% for a score ��2 and 4.8% for TIMI?<?2 (P?<?0.001). The NHF/CSANZ guideline identified more patients as low risk compared with the TIMI risk score (61% vs 48%, P?<?0.001). Conclusions: The NHF/CSANZ guideline is superior to the TIMI risk score for risk stratification of suspected ACS in the ED. ""Objective: Access block (AB) and hospital overcrowding adversely affect ED functionality. ED throughput measures have been described in the literature with positive impacts on key performance indicators (KPIs) �C time to first seen, did-not-wait rates, off-stretcher times for ambulances and ED length of stay figures. In this study, <a href="http://www.selleck.cn/products/dabrafenib-gsk2118436.html">Dabrafenib we aimed to assess the impact of a new model of care, the Senior Streaming Assessment Further Evaluation after Triage (SAFE-T) zone concept Doxorubicin solubility dmso on ED performance indicators and statistical outcomes. Methods: We implemented a model of care at our tertiary hospital ED amalgamating multiple ED throughput interventions. These interventions included dynamic transition waiting room concept, early senior ED physician assessment and decision-making, early streaming, acute-care bed quarantining and ED short stay and observation units. The principal intervention was the SAFE-T zone. End-point data were compared for similar periods (77?days) of 2010 and 2011 with and without the new model of care. Results: In total, 11?408 and 11?845 patients were included in the study periods pre- and post-intervention, respectively. Time to physician KPI improved from 72.5% to 84.1%. Did-not-wait rates dropped from 10.7% to 9.6% (P= 0.02) and off-stretcher times for ambulances KPI improved from 74.5% to 79.5% (P < 0.001). ED length of stay dropped most significantly for Australasian Triage Scale categories 3 and 4 (14.3% and 11.8%, P-values <0.001). These results were achieved despite worsened AB and hospital bed-occupancy rates during the intervention period (+3.9% and +6.7%).</div>
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