Back to Search
Start Over
Comparison of Three Risk Stratification Rules for Predicting Patients With Acute Coronary Syndrome Presenting to an Australian Emergency Department.
- Source :
-
Heart, Lung & Circulation . Oct2013, Vol. 22 Issue 10, p844-851. 8p. - Publication Year :
- 2013
-
Abstract
- Objectives: To compare the predictive ability of three risk stratification tools used to assess patients presenting to the ED with potential acute coronary syndrome. Design: Pre-planned analysis of an observational study. Setting: A single tertiary referral hospital. Participants: 1495 patients presented with chest pain. 948 patients were screened and enrolled. Patients with at least 5min of chest pain suggestive of ACS were eligible. Interventions: Subjects were risk categorised using the Heart Foundation of Australia/Cardiac Society of Australia and New Zealand guidelines (HFA/CSANZ), the TIMI score and the GRACE score. Three strata of the TIMI and GRACE score were used to compare to the HFA/CSANZ risk categories. Main outcome measurement: 30-Day cardiac event rates including cardiac death, acute myocardial infarction and unstable angina. Results: There were 152 events in 91 patients (9.6%). The discriminatory ability of the scores determined by the AUC was 0.83 (95% CI 0.79–0.87) for the GRACE score, 0.79 (95% CI 0.74–0.83) for TIMI score and 0.75 (95% CI 0.70–0.80) for HFA/CSANZ. The AUCs with three strata of the GRACE and TIMI scores were 0.76 (95% CI 0.72–0.81) and 0.68 (95% CI 0.62–0.73) respectively. Conclusions: All three scores were similar in performance in quantifying risk in ED patients with possible ACS. The GRACE score identified a sizable low risk cohort with high sensitivity and NPV but complexity of this tool may limit its utility. Improved scores are needed to allow early identification of low- and high-risk patients to support improvements in patient flow and ED overcrowding. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14439506
- Volume :
- 22
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- Heart, Lung & Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 90630588
- Full Text :
- https://doi.org/10.1016/j.hlc.2013.03.074