Combination of Goldman Risk and Initial Cardiac Troponin I for Emergency Department Chest Pain Patient Risk Stratification

• Published in: Academic emergency medicine 2001-07, Vol.8 (7), p.696-702
• Main Authors: Limkakeng, Alex, Gibler, W. Brian, Pollack, Charles, Hoekstra, James W., Sites, Frank, Shofer, Frances S., Tiffany, Brian, Wilke, Eric, Hollander, Judd E.
• Format: Article
• Language: English
• Subjects: acute coronary syndrome; Aged; Algorithms; Angioplasty, Balloon, Coronary; chest pain; Chest Pain - etiology; complications; Coronary Artery Bypass; Creatine Kinase - blood; Creatine Kinase, MB Form; Electrocardiography - methods; Emergency Treatment - methods; Female; Humans; Isoenzymes - blood; Male; Medical History Taking - methods; Middle Aged; myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - diagnosis; Myocardial Infarction - enzymology; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Physical Examination - methods; Prognosis; Prospective Studies; Risk Assessment - methods; Risk Factors; risk stratification; Sensitivity and Specificity; Severity of Illness Index; Troponin I - blood
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1111/j.1553-2712.2001.tb00187.x

Background: Accurate identification of low‐risk emergency department (ED) chest pain patients who may be safe for discharge has not been well defined. Goldman criteria have reliably risk‐stratified patients but have not identified any subset safe for ED release. Cardiac troponin I (cTnI) values have also been shown to risk‐stratify patients but have not identified a subset safe for ED release. Objective: To test the hypothesis that ED chest pain patients with a Goldman risk of ≤4% and a single negative cTnI (≤0.3 ng/mL) at the time of ED presentation would be safe for discharge [