An alternative tool for triaging patients with possible acute coronary symptoms before admission to a chest pain unit

作者：Tsai Kuang Chau; Lin Ray F^*; Lee Chieh; Li Ai Hsien

来源：American Journal of Emergency Medicine, 2018, 36(7): 1222-1230.

DOI：10.1016/j.ajem.2017.12.026

• Acute coronary syndrome
• Chest pain unit
• Observation unit
• Triage
• Emergency department

Objective: This study aimed to develop a triage tool to more effectively triage possible ACS patients presenting to the emergency department (ED) before admission to a protocol-driven chest pain unit (CPU).
Methods: Seven hundred ninety-three clinical cases, randomly selected from 7962 possible ACS cases, were used to develop and test an ACS triage model using cluster analysis and stepwise logistic regression.
Results: The ACS triage model, logit (suspected ACS patient)= -5.283 + 1.894 x chest pain + 1.612 x age + 1.222 x male + 0.958 x proximal radiation pain + 0.962 x shock + 0.519 x acute heart failure, with a threshold value set at 2.5, was developed to triage patients. Compared to four existing methods, the chest-pain strategy, the Zarich's strategy, the flowchart, and the heart broken index (HBI), the ACS triage model had better performance.
Conclusion: This study developed an ACS triage model for triaging possible ACS patients. The model could be used as a rapid tool in EDs to reduce the workloads of ED nurses and physicians in relation to admissions to the CPU.

• 出版日期2018-7