Utilidad de las escalas Heart y Timi en la evaluación de dolor toráxico como pbkp_redictor de eventos cardiovasculares mayores en emergencia

Abstract:

Background: The patient with chest pain who comes to the emergency room is a patient that offers a challenge since this is usually a symptom of acute coronary syndrome (ACS), but a significant percentage will not be. Differentiating true positives helps reduce the occurrence of major acute cardiovascular events (MACE) Objectives: To determine if the HEART scale has a better prognostic capacity than TIMI to pbkp_redict ECAM at 6 weeks in patients with chest pain seen in the emergency room. Methodology: A cross-sectional study was carried out with 535 consecutive patients chosen for convenience, with chest pain, treated in the emergency department of the Abel Gilbert Pontón Hospital, Guayaquil. They must have had an electrocardiogram, at least 2 enzyme evaluations, a minimum follow-up of 6 weeks. Patients transferred to other institutions and patients with established ACS were excluded. Patients were to be evaluated with TIMI and HEART. The end point to be evaluated was the presence of ECAM to establish the diagnostic yield. Results: 56.6% of the patients were men and 43.4% women, 35.7% were ≥65 years of age. The prevalence of DCM was 8.2%. With HEART, correct diagnoses were 39.8%; Sensitivity 97%, Specificity 34.6%, PPV 11.8%, NPV 99.4%, LH+ 1.9%, LH- 0.1. With TIMI, the percentage of correct diagnoses was 66.4%. sensitivity 90.9%, specificity 64.2%, PPV 18.5%, NPV 98.7%, LH+ 2.5, LH- 0.1 Conclusions: The two tests have a better performance, ruling out pictures of patients without ECAM at 6 weeks, not confirming them, however, TIMI achieves a greater number of correct diagnoses.

Año de publicación:

2023

Keywords:

• ESCALA HEART
• Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón
• CANTÓN GUAYAQUIL
• Dolor en el pecho
• Urgencias médicas
• ECUADOR
• Enfermedades Cardiovasculares
• ESCALA TIMI

Fuente:

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