External validation of the SCARE score in identifying acute coronary syndromes during medical regulation of chest pain.

IF 2.3 3区医学 Q1 EMERGENCY MEDICINE

BMC Emergency Medicine Pub Date : 2025-01-31 DOI:10.1186/s12873-025-01178-z

Lemoine Augustine, Fontaine Xavier, Duval Camille, Quirin Mathilde

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引用次数: 0

Abstract

Background: Medical regulation of chest pain is challenging due to the multitude of potential diagnoses. The key challenge is to avoid misdiagnosing acute coronary syndrome while preventing over-triage. The SCARE score (based on age, sex, smoking, typical coronary pain, inaugural pain, sweats, and dispatcher's conviction) classifies patients as low, intermediate, or high risk of acute coronary syndrome. This study aimed to determine the diagnostic performance of the SCARE score among patients calling with chest pain.

Methods: This single-center prospective study was conducted at the Charleville-Mézières Emergency Medical Communication Centre. Data collection included standardized questionnaires and call tape reviews. The SCARE score was compared with final diagnoses from medical records.

Results: From October 2 to November 16, 2023, 194 patients were included, with 32 (16%) diagnosed with acute coronary syndrome. Of these, 24 patients (75%) were managed by a prehospital medical team. The AUROC for the SCARE score was 0.80 [95% CI 0.73-0.87]. At a low-risk threshold (26), sensitivity was 100% [95% CI 89-100] and specificity was 45% [95% CI 37-53]. At a high-risk threshold (36), sensitivity was 72% [95% CI 53-86] and specificity was 70% [95% CI 63-77].

Conclusion: The SCARE score exhibited excellent sensitivity and overall acceptable performance in predicting acute coronary syndrome in patients calling with non-traumatic chest pain.

Trial registration: ID-RCB 2023-A01672-43.

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在胸痛的医疗调节过程中，SCARE评分识别急性冠状动脉综合征的外部验证

背景：胸痛的医学调节是具有挑战性的，因为有许多潜在的诊断。关键的挑战是避免误诊急性冠状动脉综合征，同时防止过度分类。SCARE评分（基于年龄、性别、吸烟、典型冠状动脉疼痛、初始疼痛、出汗和调度员的信念）将患者分为低、中、高风险急性冠状动脉综合征。本研究旨在确定胸痛患者的SCARE评分的诊断性能。方法：这项单中心前瞻性研究在charleville - msamzi急救医疗通讯中心进行。数据收集包括标准化问卷调查和电话录音审查。将SCARE评分与医疗记录中的最终诊断进行比较。结果：2023年10月2日至11月16日共纳入194例患者，其中32例（16%）诊断为急性冠状动脉综合征。其中，24名患者（75%）由院前医疗小组管理。SCARE评分的AUROC为0.80 [95% CI 0.73-0.87]。在低风险阈值（26）下，敏感性为100% [95% CI 89-100]，特异性为45% [95% CI 37-53]。在高危阈值（36），敏感性为72% [95% CI 53-86]，特异性为70% [95% CI 63-77]。结论：SCARE评分在预测非外伤性胸痛患者的急性冠状动脉综合征方面表现出极好的敏感性和总体可接受的性能。试验注册：ID-RCB 2023-A01672-43。

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

BMC Emergency Medicine Medicine-Emergency Medicine

CiteScore

3.50

自引率

8.00%

发文量

178

审稿时长

29 weeks

期刊介绍： BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.