Chest pain in the emergency department: risk stratification with Manchester triage system and HEART score

Fast and accurate chest pain risk stratification in the emergency department (ED) is critical. The HEART score predicts the short-term incidence of major adverse cardiac events (MACE) in this population, dividing it in three risk categories. We aimed to describe the population with chest pain, to ch...

Full description

Saved in:
Bibliographic Details
Published in:BMC cardiovascular disorders 2015-06, Vol.15 (1), p.48-48, Article 48
Main Authors: Leite, Luís, Baptista, Rui, Leitão, Jorge, Cochicho, Joana, Breda, Filipe, Elvas, Luís, Fonseca, Isabel, Carvalho, Armando, Costa, José Nascimento
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - diagnosis
Adult
Age Factors
Aged
Aged, 80 and over
Angina Pectoris - etiology
Cardiac patients
Care and treatment
Chest Pain - etiology
Chronic kidney failure
Diagnosis
Emergency Service, Hospital
Female
Health aspects
Humans
Male
Medical research
Medicine, Experimental
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Sex Factors
Triage - methods
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Fast and accurate chest pain risk stratification in the emergency department (ED) is critical. The HEART score predicts the short-term incidence of major adverse cardiac events (MACE) in this population, dividing it in three risk categories. We aimed to describe the population with chest pain, to characterize the subgroup of patients with acute coronary syndrome (ACS) and to assess the prognostic value of Manchester triage system and of HEART score. Retrospective observational study including patients admitted to the ED of a tertiary hospital with chest pain as the presenting symptom. The primary outcome was a composite of all-cause mortality, myocardial infarction or unscheduled revascularization at 6 weeks. We enrolled 233 patients (age 58 ± 19; 55.4 % males). The most common final diagnosis was non-specific chest pain (n = 86, 36.9 %), followed by ACS (n = 22, 9.4 %). Male gender, smoking and chronic kidney disease were associated with higher risk of ACS. According to Manchester triage system, chest pain patients stratified with red or orange priority had a higher incidence of ACS (16.5 % vs. 3.8 %, p = 0.006). The application of HEART score showed that most patients were in low risk category (56.3 %). The six-week incidence of MACE in each category was 2 %, 15.6 % and 76.9 % (p 
ISSN:1471-2261
1471-2261
DOI:10.1186/s12872-015-0049-6