To evaluate clinical and healthcare utilization patterns before and after the implementation of a Chest Pain Unit (CPU) in a multidisciplinary hospital in Kazakhstan, focusing on diagnostic characteristics, revascularization rates, in-hospital mortality, hospital length of stay, and direct treatment costs.
Approach:
Participants: Included all consecutive patients with suspected acute coronary syndrome (ACS) based on ICD-10 codes I20–I22, totaling 3,716 patients, with 1,595 in the pre-implementation group and 2,121 in the post-implementation group.
Key Findings:
Higher rates of percutaneous coronary intervention (PCI) in the CPU group (OR 1.43, 95% CI 1.26–1.64, p < 0.001).
Increased frequency of acute myocardial infarction (AMI) diagnoses in the CPU group (37.6% vs. 25.1%, OR 1.80, 95% CI 1.57–2.09, p < 0.001).
No significant difference in mortality rates between groups (2.4% vs. 2.2%, p = 0.543).
Direct treatment costs were significantly higher following CPU implementation (p < 0.001).
Interpretation:
CPU implementation was associated with improved identification of AMI and increased PCI use compared to traditional emergency department care.
Limitations:
Retrospective design may introduce bias.
Single-center study limits generalizability.
Conclusion:
CPU-based pathways may enhance diagnostic accuracy and management patterns in patients with suspected ACS.
