BNP Measurement Reduces Resource Utilization for Patients With CHF Admitted Thorough the ED
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).
Congestive Heart Failure
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||BNP Measurement Reduces Resource Utilization for Patients With CHF Admitted Thorough the ED: A Clinical Development Project|
- Mean total hospital cost per subject [ Time Frame: spans from ED eval through hospitalization discharge ] [ Designated as safety issue: No ]
- Included admission rate, service assignment, discharge diagnosis, and length of stay. [ Time Frame: from ED evaluation through hospitalization discharge ] [ Designated as safety issue: No ]
Biospecimen Retention: Samples Without DNA
Original protocol specifies a single 10 ml of blood is collected and frozen from each study participant (N=200), to be available for research assays.
|Study Start Date:||December 2003|
|Study Completion Date:||March 2005|
|Primary Completion Date:||March 2005 (Final data collection date for primary outcome measure)|
BNP level from protocol blood tests initiated in the ED, reported to ED physician prior to ED disposition.
BNP level from protocol blood tests initiated in the ED, NOT reported to ED physician prior to ED disposition.
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.
|United States, Minnesota|
|Saint Marys Hospital, Mayo Clinic|
|Rochester, Minnesota, United States, 55905|
|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|