The Usefulness of a Scoring System as a Predictor of Acute Coronary Syndrome in Chest Pain with an Unclear Diagnosis in the Emergency Department
Journal of the Korean Society of Emergency Medicine
; : 55-62, 2013.
Article
en Ko
| WPRIM
| ID: wpr-217711
Biblioteca responsable:
WPRO
ABSTRACT
PURPOSE: The aim of this study was to investigate the usefulness of several risk scoring systems, such as TIMI, GRACE, HEART, and PERSUIT as predictors for acute coronary syndrome (ACS) in chest pain with an unclear diagnosis. METHODS: This study was conducted as a retrospective and observational study. Enrolled patients were classified into two groups depending on the cause of chest pain: ACS group (CG; N=80) and non-ACS group (NCG; N=42). Clinical variables, including age, gender, past history, characteristics of chest pain, final diagnosis, and risk score were analyzed according to each group. Risk scoring systems for prediction of acute coronary syndrome were compared using receiver operating characteristic curve (ROC) analysis and area under the curve (AUC). RESULTS: Significant differences in age (p<0.001), diabetes mellitus (p=0.049), prior ischemic heart disease (p<0.001), continuous chest pain (p=0.035), and severe chest pain (p=0.001) were observed between the two groups. Results of ROC analysis for each scoring system for prediction of ACS were as follows: HEART (AUC; 0.878, 95% Confidence Interval, CI; 0.806~0.930, cut-off value; 4 points, sensitivity; 90.48%, specificity; 71.25%), TIMI (AUC; 0.839, 95% CI; 0.762~0.899, cut-off value; 1 point, sensitivity 83.33%, specificity 77.50%), PERSUIT (AUC; 0.748, 95% CI; 0.661~0.822, cut-off value; 11 points, sensitivity 61.90%, specificity 77.50%), and GRACE (AUC; 0.698, 95% CI, 0.608~0.778, cut off value 102 points, sensitivity 83.33, specificity 53.75%). CONCLUSION: In comparative analysis of each scoring system, the HEART scoring system was found to be a strong predictor of ACS in chest pain with an unclear diagnosis, followed by the TIMI, PURSUIT, and GRACE scoring systems.
Palabras clave
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Tórax
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Dolor en el Pecho
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Estudios Retrospectivos
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Curva ROC
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Sensibilidad y Especificidad
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Isquemia Miocárdica
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Diabetes Mellitus
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Electrocardiografía
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Urgencias Médicas
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Síndrome Coronario Agudo
Tipo de estudio:
Diagnostic_studies
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Observational_studies
/
Prognostic_studies
Límite:
Humans
Idioma:
Ko
Revista:
Journal of the Korean Society of Emergency Medicine
Año:
2013
Tipo del documento:
Article