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Troponins have close to 100% sensitivity when drawn 6 to 12 hours after the start of chest pain in acute coronary syndrome (ACS). Length of hospital stay (LOS) is a marker of efficient hospital management. Since troponin measurements at 3 (Q3H) and 6-hour (Q6H) intervals have comparable efficacy for ACS, we suggest considering Q3H troponins as opposed to Q6H in chest pain admissions to shorten LOS. A retrospective review of 389 patients who presented to Stony Brook Southampton Hospital in 2020 and 2021 with chest pain was conducted. Two patient care strategies were examined, one involved collecting troponins Q6H and the other Q3H. 319 patients with the Q6H strategy were analyzed and 61.1% were ruled in for ACS. For the Q3H strategy, 70 patients were analyzed in which 42.9% were ruled in for ACS. LOS was defined as hours between triage and submission of discharge instructions. A two-sample t-test was performed to find correlation between frequency of troponins and LOS. A two-sample t-test assuming unequal variance was conducted to compare LOS in hours between Q6H and Q3H strategies. There was a significant difference in LOS for Q6H (M = 123, SD = 201) and Q3H (M = 66, SD = 135) troponins; t = 2.91, p = 0.002. These results suggest that LOS is lessened when troponin intervals are shorter. The variance was elevated (40249,18343), possibly due to patients who stayed longer for other needs, but mean LOS and standard deviation remained decreased both when excluding patients that stayed longer than one week, and when including all patients in the analysis. Optimizing LOS has a variety of benefits. In patients with chest pain, shortening the interval of troponin collection can lessen LOS. Studies of comparable efficacy of shorter troponin intervals in evaluation of ACS have led to the practice of trending at Q3H intervals in Europe. Our study demonstrates that trending troponins Q3H is viable in a community hospital in the United States and should be further investigated and considered in the future.

Length of stay (LOS) in the hospital for patients presenting with chest pain can be influenced by several factors. In patients evaluated for acute coronary syndrome (ACS), admission to a cardiology service may allow patients to have a shorter LOS, while admission to a non-specialty service has been shown to potentially cause worse outcomes. In this analysis, we evaluate whether specialized care decreases LOS in patients who present with chest pain. A retrospective review of 389 patients who presented to Stony Brook Southampton Hospital in 2020 and 2021 with chest pain and underwent ACS evaluation was conducted. The two strategies involved admissions to the cardiology service or to other hospital services. We analyzed 95 cardiology admissions, 56.8% of which ruled in for ACS, and 294 admissions to other hospital services, 58.2% of which ruled in for ACS. LOS was defined as hours between triage and submission of discharge instructions. A two-sample t-test was performed to find correlations between admission service and length of hospital stay. A two-sample t-test assuming unequal variance was conducted to compare LOS in hours between patients admitted to the cardiology and non-cardiology services. There was a significant difference in LOS for the cardiology service (M = 48, SD = 55) and non-cardiology service (M = 134, SD = 214) conditions; t = 6.30, p < 0.001. These results suggest that LOS is lessened when chest pain patients are admitted to the cardiology service. The variance was elevated (2985, 45849), possibly due to patients who stayed longer for other needs, but mean LOS and SD remained decreased when excluding patients that stayed longer than one week, and when including all patients in the analysis. When admitting a patient, there are many ways to optimize LOS. Admission of patients who present with chest pain to a specialty cardiology service may allow patients to have a more efficient LOS and should be further investigated and considered in the future.