Valor prognóstico do Escore de Risco GRACE versus Escore de Risco TIMI em síndromes coronarianas agudas

Correia, Luís Cláudio Lemos; Freitas, Rafael; Bittencourt, Ana Paula Santana de Vasconcellos; Souza, Alexandre C.; Almeida, Maria Luciana de; Leal, Jamile; Esteves, J. Péricles

doi:10.1590/s0066-782x2010005000036

Cited by 25 publications

(14 citation statements)

References 19 publications

(15 reference statements)

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“…The mean Global Registry of Acute Coronary Events (GRACE) score, which is a predictor of cardiovascular events for coronary disease (CAD) in patients in the unit during the observation period was 168, demonstrating their severity (high risk if greater than 140). (25) …”

Section: Resultsmentioning

confidence: 99%

Reaction time of a health care team to monitoring alarms in the intensive care unit: implications for the safety of seriously ill patients

Bridi¹,

Silva²,

Farias³

et al. 2014

Revista Brasileira De Terapia Intensiva

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ObjectiveTo define the characteristics and measure the reaction time of a health care team monitoring alarms in the intensive care unit.MethodsA quantitative, observational, and descriptive study developed at the coronary care unit of a cardiology public hospital in Rio de Janeiro state (RJ). Data were obtained from the information collected on the patients, the monitoring used, and the measurement of the team's reaction time to the alarms of multi-parameter monitors during a non-participatory field observation.ResultsEighty-eight patients were followed (49 during the day shift and 39 during the night shift). During the 40 hours of observation (20 hours during the day shift and 20 hours during the night shift), the total number of monitoring alarms was 227, with 106 alarms during the day shift and 121 during the night shift, an average of 5.7 alarms/hour. In total, 145 alarms unanswered by the team were observed, with 68 occurring during the day shift (64.15%) and 77 during the night shift (63.64%). This study demonstrated that the reaction time was longer than 10 minutes in more than 60% of the alarms, which were considered as unanswered alarms. The median reaction time of the answered alarms was 4 minutes and 54 seconds during the day shift and 4 minutes and 55 seconds during the night shift. The respiration monitoring was activated in only nine patients (23.07%) during the night shift. Regarding the alarm quality of these variables, the arrhythmia alarm was qualified in only 10 (20.40%) of the day-shift patients and the respiration alarm in four night-shift patients (44.44%).ConclusionThe programming and configuration of the physiological variables monitored and the parameters of alarms in the intensive care unit were inadequate; there was a delay and lack of response to the alarms, suggesting that relevant alarms may have been ignored by the health care team, thus compromising the patient safety.

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Section: Resultsmentioning

confidence: 99%

Reaction time of a health care team to monitoring alarms in the intensive care unit: implications for the safety of seriously ill patients

Bridi¹,

Silva²,

Farias³

et al. 2014

Revista Brasileira De Terapia Intensiva

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“…ACS is a common reason for ICU admission, and specific scores have also been developed for ACS. These scores have showed good accuracy with regard to ACS risk stratification, [15][16][17][18] and risk stratification is recommended in the ACS treatment guidelines in order to guide therapeutics. 19 Among these scores, GRACE seems to have the best performance.…”

Section: Discussionmentioning

confidence: 99%

“…19 Among these scores, GRACE seems to have the best performance. [15][16][17][18] This was developed in a large cohort of ACS patients from many countries who had not taken part in clinical trials. Moreover, it included a few variables that are usually measured upon ACS patients' admission.…”

Section: Discussionmentioning

confidence: 99%

SAPS 3, APACHE IV or GRACE: which score to choose for acute coronary syndrome patients in intensive care units?

et al. 2013

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CONTEXT AND OBJECTIVE: Acute coronary syndromes (ACS) are a common cause of intensive care unit (ICU) admission. Specific prognostic scores have been developed and validated for ACS patients and, among them, GRACE (Global Registry of Acute Coronary Events) has had the best performance. However, intensive care clinicians generally use prognostic scores developed from heterogeneous populations of critically ill patients, such as APACHE IV (Acute Physiologic and Chronic Health Evaluation IV) and SAPS 3 (Simplified Acute Physiology Score 3). The aim of this study was to evaluate and compare the performance of these three scores in a non-selected population of ACS cases.

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“…We previously reported that the GRACE risk score is a better prognostic tool than the Thrombolysis in Myocardial Infarction risk score [4]. Thus, we chose the GRACE score as the reference to test the additive value of hemoglobin.…”

Section: Discussionmentioning

confidence: 99%

“…Considering that hemoglobin values are widely available at admission, it is useful to evaluate whether this information should be considered within risk scores. Among risk scores, the Global Registry of Acute Coronary Events (GRACE) model is established as the best predictor of events [4,5]. Therefore, we aimed to test the hypothesis that hemoglobin adds prognostic value to the GRACE score by examining 225 individuals consecutively admitted with unstable angina or non-ST elevation ACS.…”

Section: Introductionmentioning

confidence: 99%

Hemoglobin Level Adds Prognostic Value to the Global Registry of Acute Coronary Events Score in Non-ST Elevation Acute Coronary Syndromes

Correia¹,

Souza²,

Sabino³

et al. 2012

Cardiology

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Objective: We aimed to test the hypothesis that hemoglobin values add prognostic information to the Global Registry of Acute Coronary Events (GRACE) score at admission in patients with non-ST elevation acute coronary syndromes (ACS). Methods: A total of 225 consecutive patients with non-ST elevation ACS were studied. Hemoglobin was measured at admission, and its prognostic value was evaluated in relation to cardiovascular events during hospitalization, defined as the composite of death or myocardial infarction. Results: The incidence of major in-hospital events was 7% (10 deaths and 5 nonfatal myocardial infarctions). Hemoglobin significantly predicted events, with a C statistic of 0.67 [95% confidence interval (CI) 0.53–0.81; p = 0.03], with 12.1 g/dl as the cutoff point of best performance. After adjustment for the GRACE score, low hemoglobin (≤12.1 g/dl) remained an independent predictor of events (odds ratio 3.9, 95% CI 1.2–13; p = 0.028). The C statistic of the GRACE score for prediction of events improved from 0.80 to 0.84 after hemoglobin was taken into account. Finally, the addition of hemoglobin to the GRACE score promoted a net reclassification improvement of 16% in identifying high-risk patients (p = 0.025). Conclusions: The present study provides preliminary evidence that hemoglobin level independently predicts recurrent events during hospitalization and improves the prognostic performance of the GRACE score in patients with non-ST elevation ACS.

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Valor prognóstico do Escore de Risco GRACE versus Escore de Risco TIMI em síndromes coronarianas agudas

Cited by 25 publications

References 19 publications

Reaction time of a health care team to monitoring alarms in the intensive care unit: implications for the safety of seriously ill patients

Reaction time of a health care team to monitoring alarms in the intensive care unit: implications for the safety of seriously ill patients

SAPS 3, APACHE IV or GRACE: which score to choose for acute coronary syndrome patients in intensive care units?

Hemoglobin Level Adds Prognostic Value to the Global Registry of Acute Coronary Events Score in Non-ST Elevation Acute Coronary Syndromes

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