HEART评分对急性胸痛患者发生心搏骤停的预测价值分析

doi:10.3761/j.issn.1672-9234.2021.01.017

Abstract

Abstract:

Objective To evaluate the accuracy of HEART score for predicting cardiac arrest in patients with chest pain in the emergency department. Methods We conducted a retrospective case-control study in a provincial emergency center from January 1,2017 to December 31,2019. The chest pain patients who experienced cardiac arrest were identified as the case group(n=71). Those who did not experienced cardiac arrest were treated as the control group(n=142). The predictive ability of HEART score and its indicators for prediction of cardiac arrest between the two groups were analyzed. Results The HEART score of the case group(7.52±1.61) was significantly higher than that of the control group(4.77±2.65)(P<0.001),and the area under the ROC curve was 0.81[95%CI(0.75~0.86),P<0.001]. With the increase of the HEART score,it showed a generally linear upward trend of the risk of cardiac arrest. The AUC of the five indicators of HEART score were：electrocardiograph(0.77),troponin(0.72),history(0.70),age(0.60),and risk factor(0.60). Conclusion HEART score performed well for predicting cardiac arrest in chest pain patients in the emergency department. We recommend that applying HEART score and establishing HEART pathway for hierarchical management of patients with chest pain.

Key words: Chest Pain, Heart Arrest, Risk prediction, HEART score

GONG Hai-rong, WU Ting-ting, ZHENG Ruo-fei, LI Hong. HEART score for predicting cardiac arrest in patients with chest pain in the emergency department[J].Chinese Journal of Nursing Education, 2021, 18(1): 81-86.

Figures/Tables 5

References 18

[1]	Bhuiya FA, Pitts SR, McCaig LF. Emergency department visits for chest pain and abdominal pain:United States,1999-2008[J]. NCHS Data Brief, 2010(43):1-8.
[2]	Pope JH, Aufderheide TP, Ruthazer R , et al. Missed diagnoses of acute cardiac ischemia in the emergency department[J]. N Engl J Med, 2000,342(16):1163-1170. doi: 10.1056/NEJM200004203421603 pmid: 10770981
[3]	Amsterdam EA, Kirk JD, Bluemke DA , et al. Testing of low-risk patients presenting to the emergency department with chest pain:a scientific statement from the American Heart Association[J]. Circulation, 2010,122(17):1756-1776. doi: 10.1161/CIR.0b013e3181ec61df pmid: 20660809
[4]	中华医学会急诊医学分会, 中国医疗保健国际交流促进会胸痛分会. 急性胸痛急诊诊疗专家共识[J]. 中华急诊医学杂志, 2019,28(4):413-420.
	Emergency Medicine Branch of Chinese Medical Association, Chest Pain Branch of China Healthcare International Exchange Promotion Association. Consensus for emergency diagnosis and treatment of acute chest pain[J]. Chin J Emerg Med, 2019,28(4):413-420.
[5]	Wright RS, Anderson JL, Adams CD , et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J]. J Am Coll Cardiol, 2011,57(19):e215-e367. doi: 10.1016/j.jacc.2011.02.011 pmid: 21545940
[6]	Six AJ, Backus BE, Kelder JC . Chest pain in the emergency room:value of the HEART score[J]. Neth Heart J, 2008,16(6):191-196. doi: 10.1007/BF03086144
[7]	Ras M, Reitsma JB, Hoes AW , et al. Secondary analysis of frequency,circumstances and consequences of calculation errors of the HEART(history,ECG,age,risk factors and troponin)score at the emergency departments of nine hospitals in the Netherlands[J]. BMJ Open, 2017,7(10):e017259. doi: 10.1136/bmjopen-2017-017259 pmid: 29061617
[8]	Fernando SM, Tran A, Cheng W , et al. Prognostic accuracy of the HEART score for prediction of major adverse cardiac events in patients presenting with chest pain:a systematic review and meta-analysis[J]. Acad Emerg Med, 2019,26(2):140-151. doi: 10.1111/acem.13649 pmid: 30375097
[9]	中华心血管病杂志编辑委员会, 胸痛规范化评估与诊断共识专家组. 胸痛规范化评估与诊断中国专家共识[J]. 中国循环杂志, 2014,29(z2):106-112.
	Editorial Committee of Chinese Journal of Cardiovascular Diseases, Expert Group on Standardized Evaluation and Diagnosis of Chest Pain . Chinese expert consensus on standardized evaluation and diagnosis of chest pain[J]. Chin Circ J, 2014,29(z2):106-112.
[10]	Backus BE, Six AJ, Kelder JC , et al. A prospective validation of the HEART score for chest pain patients at the emergency department[J]. Int J Cardiol, 2013,168(3):2153-2158. doi: 10.1016/j.ijcard.2013.01.255
[11]	Hong WL, Earnest A, Sultana P , et al. How accurate are vital signs in predicting clinical outcomes in critically ill emergency department patients[J]. Eur J Emerg Med, 2013,20(1):27-32. doi: 10.1097/MEJ.0b013e32834fdcf3
[12]	Sakamoto JT, Liu N, Koh ZX , et al. Integrating heart rate variability,vital signs,electrocardiogram,and troponin to triage chest pain patients in the ED[J]. Am J Emerg Med, 2018,36(2):185-192. doi: 10.1016/j.ajem.2017.07.054 pmid: 28743479
[13]	黄振华, 肖孝勇, 叶子 , 等. 比较HEART、GRACE评分对急诊科急性胸痛患者30天MACE预测价值[J]. 中华急诊医学杂志, 2019,28(2):203-207.
	Huang ZH, Xiao XY, Ye Z , et al. Comparison of HEART and GRACE scores for 30-day predictive value in patients with acute chest pain in emergency department[J]. Chin J Emerg Med, 2019,28(2):203-207.
[14]	Sakamoto JT, Liu N, Koh ZX , et al. Comparing HEART,TIMI,and GRACE scores for prediction of 30-day major adverse cardiac events in high acuity chest pain patients in the emergency department[J]. Int J Cardiol, 2016,221:759-764. pmid: 27428317
[15]	Backus BE, Six AJ, Kelder JC,et a1. Chest pain in the emergency room:a multicenter validation of the HEART Score[J]. Crit Pathw Cardiol, 2010,9(3):164-169. doi: 10.1097/HPC.0b013e3181ec36d8 pmid: 20802272
[16]	Laureano-Phillips J, Robinson RD, Aryal S , et al. HEART score risk stratification of low-risk chest pain patients in the emer-gency department:a systematic review and meta-analysis[J]. Ann Emerg Med, 2019,74(2):187-203. doi: 10.1016/j.annemergmed.2018.12.010 pmid: 30718010
[17]	Riley RF, Newby LK, Don CW , et al. Diagnostic time course,treatment,and in-hospital outcomes for patients with ST-segment elevation myocardial infarction presenting with nondiagnostic initial electrocardiogram:a report from the American Heart Association Mission:lifeline program[J]. Am Heart J, 2013,165(1):50-56. doi: 10.1016/j.ahj.2012.10.027
[18]	Long B, Oliver J, Streitz M , et al. An end-user's guide to the HEART score and pathway[J]. Am J Emerg Med, 2017,35(9):1350-1355. doi: 10.1016/j.ajem.2017.03.047 pmid: 28363616

HEART score for predicting cardiac arrest in patients with chest pain in the emergency department

HTML

PDF(PC)

Like

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 5

References 18

Related Articles 2

Metrics

Comments

Recommended 10

[1]	LUO Yuan, ZHANG Hua, ZHANG Mengxi, DENG Yuqian, RAN Haiye, LIU Jiaxin, ZHAO Liping. Machine learning for fall prediction and monitor of older adults：a systematic review [J]. Chinese Journal of Nursing Education, 2023, 20(12): 1513-1519.
[2]	GUAN Sui-li,XIE Feng-ru,ZHANG Xing-lian. Application of the modified early warning scoring in the triage for patients with acute chest pain [J]. 中华护理教育, 2016, 13(11): 852-854.