The challenge of triaging chest pain patients: the bernese university hospital experience

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

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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; Exadaktylos, Aristomenis Konstantinos and Arampatzis, Spyridon

ISSN:

2090-2840

Publisher:

Hindawi Publishing Corporation

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:23

Last Modified:

18 Dec 2014 19:18

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)

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