Chest pain in the emergency room: value of the HEART score
Chest pain in the emergency room: value of the HEART score
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DOI：
10.1007/bf03086144
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发表时间：
2008-06-01
影响因子：
2
通讯作者：
Kelder, J. C.
中科院分区：
文献类型：
--
作者：
Six, A. J.;Backus, B. E.;Kelder, J. C.
背景胸痛是急诊室最常见的原因之一。非ST段抬高型急性冠状动脉综合征的诊断通常会引起不确定性。危险分层的经典考虑因素包括病史、ECG、年龄、危险因素和肌钙蛋白（心脏）。根据异常的程度，每一个都可以用零分、一分或两分来评分。HEART评分是这五项评分的总和。分析了122例因胸痛而被转诊到急诊室的患者的临床资料。在120/122例患者中评估了HEART评分对达到终点的预测价值。29例患者达到一个或多个终点：16例患者诊断为急性心肌梗死，20例接受血运重建，2例死亡。有和没有终点的患者的HEART评分分别为6.51 +/- 1.84和3.71 +/- 1.83（p < 0.0001）。HEART评分为0-3分时，终点风险为2.5%，支持立即出院。风险为20.3%，HEART评分为4-6分意味着需要住院进行临床观察。HEART评分≥ 7分，风险为72.7%，支持早期介入治疗。HEART评分有助于准确的诊断和治疗选择。HEART评分是一种简单、快速、可靠的胸痛患者预后预测指标。
Background. Chest pain is one of the most common causes of presentation to the emergency room. The diagnosis of non-ST-elevation acute coronary syndrome typically causes uncertainty. Classical considerations for risk stratification are History, ECG, Age, Risk factors and Troponin (HEART). Each can be scored with zero, one or two points, depending on the extent of the abnormality. The HEART score is the sum of these five considerations.Methods. Clinical data from 122 patients referred to the emergency room for chest pain were analysed. The predictive value of the HEART score for reaching an endpoint was evaluated in 120/122 patients.Results. Twenty-nine patients reached one or more endpoints: an acute myocardial infarction was diagnosed in 16 patients, 20 underwent revascularisation and two died. The HEART score in the patients with and without an endpoint was 6.51 +/- 1.84 and 3.71 +/- 1.83 (p < 0.0001) respectively. A HEART score of 0-3 points holds a risk of 2.5% for an endpoint and supports an immediate discharge. With a risk of 20.3%, a HEART score of 4-6 points implies admission for clinical observation. A HEART score >= 7points, with a risk of 72.7%, supports early invasive strategies.Conclusion. The HEART score facilitates accurate diagnostic and therapeutic choices. The HEART score is an easy, quick and reliable predictor of outcome in chest pain patients.