Burkett, E and Marwick, T and Thom, O and Kelly, AM, A comparative analysis of risk stratification tools for emergency department patients with chest pain, International Journal of Emergency Medicine, 7, (1) Article 10. ISSN 1865-1380 (2014) [Refereed Article]
Copyright 2009 Springer
METHODS: This prospective observational study evaluated ED patients aged ≥30 years with non-traumatic chest pain for which no definitive non-ischemic cause was found. Data collected included demographic and clinical information, investigation findings and occurrence of MACE by 30 days. The outcome of interest was the comparative predictive performance of the risk tools for MACE at 30 days, as analyzed by receiver operator curves (ROC).
RESULTS: Two hundred eighty-one patients were studied; the rate of MACE was 14.1%. Area under the curve (AUC) of the HFA, TIMI RS and Goldman tools for the endpoint of MACE was 0.54, 0.71 and 0.67, respectively, with the difference between the tools in predictive ability for MACE being highly significant [chi2 (3) = 67.21, N = 276, p < 0.0001].
CONCLUSION: The TIMI RS and Goldman tools performed better than the HFA in this undifferentiated ED chest pain population, but selection of cutoffs balancing sensitivity and specificity was problematic. There is an urgent need for validated risk stratification tools specific for the ED chest pain population.
|Item Type:||Refereed Article|
|Keywords:||Chest pain; Emergency department; Goldman risk score; Risk score; TIMI|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Marwick, T (Professor Tom Marwick)|
|Deposited By:||Menzies Institute for Medical Research|
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