The development of a decision support tool in the prehospital setting for acute chest pain - a study protocol for an observational study (BRIAN2).

IF 3 2区医学 Q1 EMERGENCY MEDICINE

Scandinavian Journal of Trauma Resuscitation & Emergency Medicine Pub Date : 2025-01-06 DOI:10.1186/s13049-024-01314-x

Elin Lökholm, Carl Magnusson, Johan Herlitz, Annica Ravn-Fischer, Ola Hammarsten, Magnus Johansson, Kristoffer Hallin, Kristoffer Wibring

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引用次数: 0

Abstract

Introduction: Chest pain is one of the most common reasons for contacting the emergency medical services (EMS). It is difficult for EMS personnel to distinguish between patients suffering from a high-risk condition in need of prompt hospital care and patients suitable for non-conveyance. A vast majority of patients with chest pain are therefore transported to the emergency department (ED) for further investigation even if hospital care is not necessary. Improved prehospital assessment and risk stratification, thus accurately and safely identifying patients suitable for non-conveyance, could prevent unnecessary transport to the ED. This would reduce ED crowding and overburdening sparse EMS resources. It would thus also probably reduce healthcare costs. Little is known about the prehospital use of the 5th generation, i.e. high-sensitivity troponin analyses. The aim of this project is to develop an EMS decision support tool using high-sensitivity troponin I for risk assessment of chest pain patients.

Methods and analysis: This is a prospective, multicentre, cohort study including adult unselected EMS patients with chest pain. Data is being collected from 20 May 2023 to 31 December 2025, aiming to include at least 2,000 patients. High-sensitivity troponin I is being analysed bedside using Siemens Healthineers Atellica VTLi. In addition to prehospital troponin I, data is being collected on patient medical history, onset, vital signs, symptoms, ECG and diagnosis at hospital discharge. Several statistical analyses (random forest, logistic regression, gradient boosting) will be conducted to identify the best model for identifying patients with low-risk conditions suitable for non-conveyance.

Ethics and dissemination: The study has been approved by the Swedish Ethical Review Authority (Dnr 2022-01066-01 and 2022-06846-02). Patients are being informed about the study both orally and in writing. The results of the study will be published in a peer-reviewed journal and will be presented at national and/or international conferences.

Registration details: The study is registered at ClinicalTrials.gov (NCT05767619).

查看原文本刊更多论文

院前急性胸痛决策支持工具的开发——一项观察性研究的研究方案（BRIAN2）。

胸痛是联系紧急医疗服务（EMS）的最常见原因之一。急救人员很难区分需要及时住院治疗的高危患者和不需要转运的患者。因此，即使不需要住院治疗，绝大多数胸痛患者也会被送往急诊科（ED）进行进一步检查。改进院前评估和风险分层，从而准确、安全地识别适合不转运的患者，可以防止不必要的转运到急诊科。这将减少急诊科的拥挤和对稀疏的EMS资源的过重负担。因此，这也可能降低医疗成本。关于院前使用第五代，即高灵敏度肌钙蛋白分析知之甚少。该项目的目的是开发一种EMS决策支持工具，使用高灵敏度肌钙蛋白I来评估胸痛患者的风险。方法和分析：这是一项前瞻性、多中心、队列研究，包括未选择的胸痛EMS成年患者。数据收集时间为2023年5月20日至2025年12月31日，目标是纳入至少2000名患者。高灵敏度肌钙蛋白I正在使用西门子Healthineers Atellica VTLi进行床边分析。除了院前肌钙蛋白I外，还收集有关患者病史、发病、生命体征、症状、心电图和出院时诊断的数据。将进行几种统计分析（随机森林、逻辑回归、梯度增强），以确定识别适合非运输的低风险患者的最佳模型。伦理和传播：该研究已获得瑞典伦理审查局（Dnr 2022-01066-01和2022-06846-02）的批准。患者被口头和书面告知了这项研究。研究结果将发表在同行评议的期刊上，并将在国家和/或国际会议上发表。注册详情：该研究已在ClinicalTrials.gov注册（NCT05767619）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Scandinavian Journal of Trauma Resuscitation & Emergency Medicine EMERGENCY MEDICINE-

CiteScore

6.10

自引率

6.10%

发文量

审稿时长

6-12 weeks

期刊介绍： The primary topics of interest in Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (SJTREM) are the pre-hospital and early in-hospital diagnostic and therapeutic aspects of emergency medicine, trauma, and resuscitation. Contributions focusing on dispatch, major incidents, etiology, pathophysiology, rehabilitation, epidemiology, prevention, education, training, implementation, work environment, as well as ethical and socio-economic aspects may also be assessed for publication.