急诊科胸痛风险分层:当前视角。

IF 1.5 Q3 EMERGENCY MEDICINE Open Access Emergency Medicine Pub Date : 2024-02-04 eCollection Date: 2024-01-01 DOI:10.2147/OAEM.S419657
Zeynep Yukselen, Vidit Majmundar, Mahati Dasari, Pramukh Arun Kumar, Yuvaraj Singh
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引用次数: 0

摘要

胸痛是美国成年人急诊科(ED)就诊的第二大原因,每年有近 1100 万人次就诊。识别低风险患者对于尽早出院至关重要,而在急诊科识别高风险患者对于及时、适当地处理急性冠状动脉综合征(ACS)也至关重要。体格检查、心脏标志物或影像学检查等传统方法不能可靠地确认或排除 ACS,也不能单独用于对患者进行风险分层。为了应对这一挑战,人们提出了各种临床风险评分,以便对疑似 ACS 患者进行风险分层。理想的风险评分应具有较高的灵敏度和特异性,以准确区分不同风险水平的患者,尤其是在识别主要不良心血管事件的高风险患者方面。同时,理想的评分系统还应能够计算出需要及时干预和检查的其他非冠状动脉病因胸痛(如主动脉夹层和肺栓塞)的信息。在本综述中,我们收集了用于对急诊室急性胸痛患者进行风险分层的主要风险评分。我们缩写了这些评分的突出特点,以帮助读者做出临床决策。
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Chest Pain Risk Stratification in the Emergency Department: Current Perspectives.

Chest pain is the second leading cause of all emergency department (ED) visits in adults in the United States, with nearly 11 million encounters yearly. While identifying low-risk patients is crucial for early discharge, identifying high-risk patients in ED is vital in timely and appropriate acute coronary syndrome (ACS) management. Traditional methods such as physical examination, cardiac markers, or imaging tests cannot reliably confirm or rule out ACS; they cannot be singularly incorporated to risk stratify patients. Various clinical risk scores have been proposed to address this challenge for risk stratification in patients being evaluated for suspected ACS. The ideal risk score should demonstrate high sensitivity and specificity to accurately differentiate between patients with varying levels of risk, particularly in identifying those at high risk for major adverse cardiovascular events. Simultaneously, an ideal scoring system should also be able to compute information for other non-coronary etiologies of chest pain that require time-sensitive interventions and workups (eg, aortic dissection and pulmonary embolism). In this review, we have assembled major risk scores used for risk stratification in patients with acute chest pain in ED. We have abbreviated their salient features to assist readers in their clinical decision-making.

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来源期刊
Open Access Emergency Medicine
Open Access Emergency Medicine EMERGENCY MEDICINE-
CiteScore
2.60
自引率
6.70%
发文量
85
审稿时长
16 weeks
期刊最新文献
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