Emergency room risk stratification of patients with chest pain without ST segment elevation
Joint Authors
Ismail, Imad al-Din
al-Baih, Adil H.
Ismail, Munirah T.
al-Imam, Yahya
Nasr, Gamela
Source
Suez Canal University Medical Journal
Issue
Vol. 19, Issue 1 (30 Jun. 2016), pp.68-75, 8 p.
Publisher
Suez Canal University Faculty of Medicine
Publication Date
2016-06-30
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Background : Emergency room triage of patients with chest pain is an ongoing challenge.
Over the years a number of modalities have been evolved for rapid diagnosis and better risk stratification of patients.
Aim: to investigate the prognostic factors in patients who came to the Emergency Department with chest pain suspected of acute coronary syn-drome without ST segment elevation.
Patients and Methods: one-hundred and three consecutive patients (from Suez Canal university Hospital and Al Monira General Hospi-tal) were evaluated by recording clinical history, electrocardiogram and troponin de-termination.
Early (< 24 h) exercise testing was done for the low-risk subgroup of pa-tients (n= 28).
All patients were followed up for 3 months for major events (acute myo-cardial infarction or death).
Results: Major events occurred in 14 patients (9.6%).
Multi-variate analysis identified the following predictors: age ≥65 years (OR = 1.7; p = 0.05), diabetes mellitus (OR = 2.9; p = 0.001), previous ischemic heart disease (OR = 2.5; p = 0.004), ST depression (OR = 2.1; p = 0.048) and troponin elevation (OR = 2.6; p = 0.003).
These five predictors were used to construct a risk score based on their odds ratios, which allowed event risk stratification 0-3 points low risk 48 % of the studied patients, 4-7 points intermediate risk 31% of the studied patients, 8 points or more high risk 21%of studied patients.
Conclusions: In patients with chest pain, the combination of clinical, electrocardiographic and biochemical data available on admission to the emergency service allows rapid prognostic stratification.
Early exercise testing is advisable for the final stratification of low risk patients.
American Psychological Association (APA)
Ismail, Imad al-Din& Nasr, Gamela& al-Baih, Adil H.& Ismail, Munirah T.& al-Imam, Yahya. 2016. Emergency room risk stratification of patients with chest pain without ST segment elevation. Suez Canal University Medical Journal،Vol. 19, no. 1, pp.68-75.
https://search.emarefa.net/detail/BIM-959130
Modern Language Association (MLA)
Ismail, Imad al-Din…[et al.]. Emergency room risk stratification of patients with chest pain without ST segment elevation. Suez Canal University Medical Journal Vol. 19, no. 1 (2016), pp.68-75.
https://search.emarefa.net/detail/BIM-959130
American Medical Association (AMA)
Ismail, Imad al-Din& Nasr, Gamela& al-Baih, Adil H.& Ismail, Munirah T.& al-Imam, Yahya. Emergency room risk stratification of patients with chest pain without ST segment elevation. Suez Canal University Medical Journal. 2016. Vol. 19, no. 1, pp.68-75.
https://search.emarefa.net/detail/BIM-959130
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 75
Record ID
BIM-959130