顺化医科大学附属医院急诊与脑卒中中心心脏评分在胸痛患者风险分层中的应用研究

Huy Nguyen Khanh
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引用次数: 0

摘要

背景:胸痛是到急诊科就诊的最常见原因之一,约占非损伤相关就诊的10%。冠状动脉疾病是引起胸痛的重要原因,应及早诊断和治疗。HEART评分旨在对急诊无分化胸痛患者的风险进行分层,识别需要更多资源或需要早期急诊治疗的高危患者,以及避免不必要住院治疗的低危患者。在我的国家,关于心脏评分的研究还不多。目的:评价心绞痛在急诊科胸痛患者危险分层中的价值。方法:数据来自顺化大学医院急诊卒中中心70例胸痛患者。计算HEART评分。结果为首次就诊后30天内MACE(死亡率、AMI、PCI、CABG)的发生情况。结果:患者平均年龄63.80岁,67.10%为女性,41.40%有高血压病史,21.40%有PCI病史。14.30%的患者达到治疗效果。30天MACE患者HEART评分在0 ~ 3、4 ~ 6、7 ~ 10之间的比例分别为4.30%、10.50%、55.60%。cut- cut≥4点时,HEART评分对研究组事件具有预测价值,敏感性为90%,特异性为63.3%,ROC曲线下面积为0.86 (95% CI 0.71 ~ 1.00)。结论:心脏评分对急诊科胸痛患者的危险分层有一定的价值。关键词:心脏评分胸痛急诊科
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Study on application of the HEART score in stratifying risk among patients with chest pain in the Emergency and Stroke Center of Hue University of Medicine and Pharmacy Hospital
Background: Chest pain is one of the most common reasons to attend the emergency department, accounting for approximately 10% of non-injury-related visits. Coronary artery disease is an important cause of chest pain that should be evaluated and managed early. The HEART score is designed to stratify the risk of emergency patients with undifferentiated chest pain, to identify high-risk patients who require more resources or need early emergency treatment, and low-risk patients to avoid unnecessary hospitalization. In my country, there have not been many studies on the HEART score yet. Objective: To evaluate the value of the HEART sore in risk stratification among patients with chest pain in the emergency department. Methods: Data used from 70 patients presented with chest pain to Emergency-Stroke Center of Hue university hospital. The HEART score was calculated. Outcome was occurrence of MACE (mortality, AMI, PCI, CABG) within 30-days of initial presentation. Results: Patient demographics include an average age of 63.80, 67.10% female, and 41.40% with history of hypertension, 21.40% with history PCI. 14.30% of patients met the outcome. The percent of patients with 30-day MACE with HEART score between 0 and 3, 4 - 6, and 7 - 10 was 4.30%, 10.50%, and 55.60%, respectively. With the cut-off of ≥ 4 points, the HEART score had prognostic value for the events in the study group with a sensitivity of 90%, a specificity of 63.3%, the area under the ROC curve was 0.86 (95% CI 0.71 - 1.00). Conclusion: The HEART score was valuable in risk stratification patients with chest pain in emergency department. Key words: HEART score, chest pain, emergency department.
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