Validation of the RETRIEVE (REverse TRIage EVEnts) Criteria for Same Day Return of Non-ST Elevation Acute Coronary Syndrome Patients to Referring Non-PCI Centres

Sonya N Burgess; Vu Huynh Nguyen; James Xu; Yoshio Hinde; Anoop Dharmadmajan; Xavier Brennan; Karen Owen; Karen Lintern; Craig Juergens; Sidney Lo; Phong Nguyen; Krishna K Kadappu; John K French; Rohan Rajaratnam

doi:10.1016/j.hlc.2017.08.005

Validation of the RETRIEVE (REverse TRIage EVEnts) Criteria for Same Day Return of Non-ST Elevation Acute Coronary Syndrome Patients to Referring Non-PCI Centres

Heart Lung Circ. 2018 Jul;27(7):792-797. doi: 10.1016/j.hlc.2017.08.005. Epub 2017 Aug 19.

Authors

Affiliations

¹ Department of Cardiology, Liverpool Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia.
² Department of Cardiology, Campbelltown Hospital, Sydney, NSW, Australia.
³ Department of Cardiology, Campbelltown Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia.
⁴ Department of Cardiology, Liverpool Hospital, Sydney, NSW, Australia; Department of Cardiology, Campbelltown Hospital, Sydney, NSW, Australia.
⁵ Department of Cardiology, Liverpool Hospital, Sydney, NSW, Australia; Department of Cardiology, Campbelltown Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia.
⁶ Department of Cardiology, Liverpool Hospital, Sydney, NSW, Australia; Department of Cardiology, Campbelltown Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia; Western Sydney University, Sydney, NSW, Australia. Electronic address: Rohan.Rajaratnam@sswahs.nsw.gov.au.

PMID: 28919071
DOI: 10.1016/j.hlc.2017.08.005

Abstract

Background: There are continuing bed constraints in percutaneous coronary intervention centres (PCI) so efficient patient triage from referral hospitals is pivotal. To evaluate a strategy of PCI centre (PCIC) bed-sparing we examined return of patients to referral hospitals screened by the RETRIEVE (REverse TRIage EVEnts) criteria and validated its use as a tool for screening suitability for same day transfer of non-ST-elevation acute coronary syndrome (NSTEACS) patients post PCI to their referring non-PCI centre (NPCIC).

Methods: From May 2008 to May 2011, 433 NSTEACS patients were prospectively screened for suitability for same day transfer back to the referring hospital at the completion of PCI. Of these patients, 212 were excluded from same day transfer using the RETRIEVE criteria and 221 patients met the RETRIEVE criteria and were transferred back to their NPCIC.

Results: Over the study period, 218 patients (98.6%) had no major adverse events. The primary endpoint (death, arrhythmia, myocardial infarction, major bleeding event, cerebrovascular accident, major vascular site complication, or requirement for return to the PCIC) was seen in only three transferred patients (1.4%).

Conclusions: The RETRIEVE criteria can be used successfully to identify NSTEACS patients suitable for transfer back to NPCIC following PCI. Same day transfer to a NPCIC using the RETRIEVE criteria was associated with very low rates of major complications or repeat transfer and appears to be as safe as routine overnight observation in a PCIC.

Keywords: Acute coronary syndrome; Bed block; Hospital over-crowding; Percutaneous coronary intervention; Same day transfer; Systems of care.

Publication types

Multicenter Study
Validation Study

MeSH terms

Acute Coronary Syndrome / surgery*
Coronary Angiography
Electrocardiography*
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
New South Wales / epidemiology
Patient Readmission / trends*
Patient Transfer*
Percutaneous Coronary Intervention / methods*
Postoperative Complications / epidemiology*
Prospective Studies
Treatment Outcome
Triage / organization & administration*