Clinical utility of the HEART score in patients admitted with chest pain to an inner-city hospital in the USA.
Coron Artery Dis
; 28(4): 336-341, 2017 Jun.
Article
em En
| MEDLINE
| ID: mdl-28288007
ABSTRACT
BACKGROUND:
Chest pain is one of the most common presentations to a hospital, and appropriate triaging of these patients can be challenging. The HEART score has been used for such purposes in some countries and only a few validation studies from the USA are available. We aim to determine the utility of the HEART score in patients presenting with chest pain to an inner-city hospital in the USA. PATIENTS ANDMETHODS:
We retrospectively screened 417 consecutive patients admitted with chest pain to the observation/telemetry units at Einstein Medical Center Philadelphia. After applying inclusion and exclusion criteria, 299 patients were included in the analysis. Patients were divided into low-risk (0-3) and intermediate-high (≥4)-risk HEART score groups. Baseline characteristics, thrombolysis in myocardial infarction score, need for revascularization during index hospitalization, and major adverse cardiovascular events (MACE) at 6 weeks and 12 months were recorded.RESULTS:
There were 98 and 201 patients in the low-score group and intermediate-high-score group, respectively. Compared with the low-score group, patients in the intermediate-high-risk group had a higher incidence of revascularization during the index hospital stay (16.4 vs. 0%; P=0.001), longer hospital stay, higher MACE at 6 weeks (9.5 vs. 0%) and 12 months (20.4 vs. 3.1%), and higher cardiac readmissions. HEART score of at least 4 independently predicted MACE at 12 months (odds ratio 7.456, 95% confidence interval 2.175-25.56; P=0.001) after adjusting for other risk factors in regression analysis.CONCLUSION:
HEART score of at least 4 was predictive of worse outcomes in patients with chest pain in an inner-city USA hospital. If validated in multicenter prospective studies, the HEART score could potentially be useful in risk-stratifying patients presenting with chest pain in the USA and could impact clinical decision-making.
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Base de dados:
MEDLINE
Assunto principal:
Admissão do Paciente
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Hospitais Urbanos
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Dor no Peito
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Medição de Risco
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Síndrome Coronariana Aguda
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Infarto do Miocárdio sem Supradesnível do Segmento ST
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article