42 A cross-sectional study in CVD prevention in the ED: wouldn’t it be NICE to make every contact count?

<h3>Background</h3> Cardiovascular disease (CVD) remains a significant public health issue, and national policy emphasises disease prevention and timely risk factor detection in its management. The National Institute for Health and Care Excellence (NICE) developed CG181 guidance outlining methods to identify and manage patients at high risk of developing CVD. It is currently unclear whether guidance is adhered to, and if further opportunities could be taken within Emergency Care to optimise CVD prevention. <h3>Aim</h3> This cross-sectional study assessed local healthcare service compliance with CG181 guidance and aimed to make recommendations where appropriate. <h3>Methods</h3> Records of all 405 patients who presented to the Emergency Department (ED) of a Merseyside Hospital Trust within a 24-hour period in 2022 were reviewed. This study calculated QRISK scores for patients with outlined characteristics qualifying them for formal risk assessment, using information routinely collected during their ED admission. <h3>Results</h3> Results indicate inconsistencies between guidance and practice. NICE states that patients with certain pre-existing diseases and those with a QRISK&gt;10% should receive statins, and this study found that only 82% and 43% respectively did so. Zero patients had a QRISK score calculated in the ED. If QRISK scores could be calculated within the ED, potentially 40 additional patients daily could be identified as having elevated CVD risk with data that is routinely gathered. The report highlights the use of Artificial Intelligence in the automated generation of QRISK scores and auto-population of information on discharge paperwork. The positioning of primary care staff in the ED to undertake direct intervention is also considered. <h3>Conclusion</h3> While primary prevention of CVD is largely managed within primary care, this study highlights a potential role for the ED in ‘making every contact with healthcare count’. The considerable information routinely generated during an ED visit could improve CVD detection and management, but is currently overlooked.