Rohacek, Martin; Bertolotti, Amina; Grützmüller, Nadine; Simmen, Urs; Marty, Hans; Zimmermann, Heinz; Exadaktylos, Aristomenis; Spyridon, Arampatzis (2012). The challenge of triaging chest pain patients: the bernese university hospital experience. Emergency medicine international, 2012, p. 975614. Cairo (Egypt): Hindawi Publishing Corporation 10.1155/2012/975614
|
Text
141236.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (1MB) | Preview |
Accurate diagnosis of the causes of chest pain and dyspnea remain challenging. In this preliminary observational study with a 5-year follow-up, we attempted to find a simplified approach to selecting patients with chest pain needing immediate care based on the initial evaluation in ED. During a 24-month period were randomly selected 301 patients and a conditional inference tree (CIT) was used as the basis of the prognostic rule. Common diagnoses were musculoskeletal chest pain (27%), ACS (19%) and panic attack (12%). Using variables of ACS symptoms we estimated the likelihood of ACS based on a CIT to be high at 91% (32), low at 4% (198) and intermediate at 20.5-40% in (71) patients. Coronary catheterization was performed within 24 hours in 91% of the patients with ACS. A culprit lesion was found in 79%. Follow-up (median 4.2 years) information was available for 70% of the patients. Of the 164 patients without ACS who were followed up, 5 were treated with revascularization for stable angina pectoris, 2 were treated with revascularization for myocardial infarction, and 25 died. Although a simple triage decision tree could theoretically help to efficient select patients needing immediate care we need also to be vigilant for those presenting with atypical symptoms.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center 04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension |
UniBE Contributor: |
Rohacek, Martin, Marty, Hans Ulrich, Zimmermann, Heinz (B), Exadaktylos, Aristomenis, Arampatzis, Spyridon |
ISSN: |
2090-2840 |
Publisher: |
Hindawi Publishing Corporation |
Language: |
English |
Submitter: |
Factscience Import |
Date Deposited: |
04 Oct 2013 14:23 |
Last Modified: |
14 Jan 2024 00:19 |
Publisher DOI: |
10.1155/2012/975614 |
PubMed ID: |
22114740 |
BORIS DOI: |
10.7892/boris.7835 |
URI: |
https://boris.unibe.ch/id/eprint/7835 (FactScience: 213184) |
Actions (login required)
 |
Edit item |