A computer protocol to evaluate subjects with chest pain in the emergency department: a multicenter study
| Autor: | Francesco Mazzuoli, Mirco Magnani, Cristina Barbieri, Roberto Lorenzoni, Fabio Lattanzi, Alessandra Mazzoni, Alberto Genovesi Ebert, Enrico Orsini, Marco Rossi |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Chest Pain medicine.medical_specialty Adolescent Coronary Disease Chest pain Decision Support Techniques Clinical Protocols Positive predicative value medicine Humans Aged Probability Aged 80 and over Protocol (science) business.industry Incidence (epidemiology) Coronary Care Units General Medicine Emergency department Middle Aged Patient Discharge Italy Multicenter study Anesthesia Multivariate Analysis Emergency medicine Coronary care unit Female Differential diagnosis medicine.symptom Emergency Service Hospital Cardiology and Cardiovascular Medicine business Algorithms |
| Zdroj: | Journal of Cardiovascular Medicine. 7:203-209 |
| ISSN: | 1558-2027 |
| Popis: | OBJECTIVE Chest pain is a frequent cause of medical admission to the emergency department and the main differential diagnosis is between coronary and non-coronary chest pain. We elaborated a computer protocol for the management of patients with chest pain. METHODS The computer protocol was made of three sections according to clinical, electrocardiographic and biochemical data. Each section was coded by a letter indicating the probability of coronary chest pain for each section. The combination of the three letters formed a score string used to assign patients to four subgroups of overall probability of coronary chest pain (low, medium-low, medium-high, and high). Low-probability patients were discharged from the emergency department, whereas high-probability patients were admitted to the coronary care unit. The medium-probability patients underwent further evaluation by means of a stress test and were re-classified as having a final low probability (negative test) or high probability (positive test). RESULTS We evaluated 472 patients (mean age 64 years, range 18-97 years; 47% female). The incidence of coronary events in patients with low, medium-low, medium-high and high overall probability was 1.9, 12.8,13.5 and 68.0%, respectively (P < 0.05). The positive and negative predictive values of the protocol were 64.7 and 97.1%, respectively. CONCLUSIONS Our computer protocol represents a reliable method for the management of patients with chest pain and a non-diagnostic electrocardiogram. |
| Databáze: | OpenAIRE |
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