Risk Stratification in Chest Pain: Impact on the Diagnosis of Acute Coronary Syndrome

Reis, Ana Paula Paz; Ruschel, Karen Brasil; Moraes, Maria Antonieta; Belli, Karlyse Claudino; Saffi, Marco Lumertz; Fagundes, Jaqueline Eilert

doi:10.36660/ijcs.20190178

Cited by 3 publications

(3 citation statements)

References 15 publications

(15 reference statements)

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“…Initially, clinical manifestations of ACS occur following a decrease in local circulation due to luminal narrowing. This commonly presents as a pressure chest pain that radiates to the left or right upper limb or mandible and may be associated with cold sweating, nausea, abdominal pain, or lipothymia [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Care Interventions on the Survival of Patients with Cardiac Chest Pain

et al. 2023

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Background: Chest pain is considered the second most frequent complaint among patients seeking emergency services. However, there is limited information in the literature about how the care provided to patients with chest pain, when being attended to in the emergency room, influences their clinical outcomes. Aims: To assess the relationship between care interventions performed on patients with cardiac chest pain and their immediate and late clinical outcomes and to identify which care interventions were essential to survival. Methods: In this retrospective study. We analyzed 153 medical records of patients presenting with chest pain at an emergency service center, São Paulo, Brazil. Participants were divided into two groups: (G1) remained hospitalized for a maximum of 24 h and (G2) remained hospitalized for between 25 h and 30 days. Results: Most of the participants were male 99 (64.7%), with a mean age of 63.2 years. The interventions central venous catheter, non-invasive blood pressure monitoring, pulse oximetry, and monitoring peripheral perfusion were commonly associated with survival at 24 h and 30 days. Advanced cardiovascular life support and basic support life (p = 0.0145; OR = 8053; 95% CI = 1385–46,833), blood transfusion (p < 0.0077; OR = 34,367; 95% CI = 6489–182,106), central venous catheter (p < 0.0001; OR = 7.69: 95% CI 1853–31,905), and monitoring peripheral perfusion (p < 0.0001; OR = 6835; 95% CI 1349–34,634) were independently associated with survival at 30 days by Cox Regression. Conclusions: Even though there have been many technological advances over the past decades, this study demonstrated that immediate and long-term survival depended on interventions received in an emergency room for many patients.

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Section: Introductionmentioning

confidence: 99%

Impact of Care Interventions on the Survival of Patients with Cardiac Chest Pain

et al. 2023

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“…It is known that there are different classification protocols, and some of them allow more subjectivity in the evaluation than others, even if evaluators follow the same parameters to determine the severity and priority of care (10,11) .…”

Section: Introductionmentioning

confidence: 99%

Determining factors of service priority in the risk classification of patients with chest pain

Segalla,

Santos,

Reis

et al. 2023

Rev. Gaúcha Enferm.

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Objective: To verify the determining factors of high priority in the risk classification and the outcomes of the care provided to adult patients with chest pain. Method: Retrospective study, conducted at an emergency referral service of a public hospital in the interior of São Paulo State, analyzing the records of care performed in the risk classification in 181 medical records of patients with the symptom of chest pain, between August and November 2020. Results: Individuals were most males 98 (54.1%), with moderate pain 133 (73.5), high priority for care 135 (74.5%) and who sought the service spontaneously 139 (76.8%). Of those classified as high priority, 47 (34.8%) were referred to the emergency room and, of these, 27 (17.0%) remained hospitalized. Female gender (p=0.0198; OR=0.40; CI=0.189-0.866) was independently associated with high priority of care. Conclusion: Despite the priority classification, few participants were referred to the emergency room and required hospitalization. Female gender was a protective factor in the risk classification as high priority.

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“…Sabe-seque há diferentes protocolos de classificação e alguns permitem mais subjetividade na avaliação que outros, mesmo que os avaliadores sigam os mesmos parâmetros de avaliação para estabelecer a gravidade e prioridade do atendimento (10,11) .…”

Section: Introductionunclassified

Fatores determinantes de prioridade de atendimento na classificação de risco a pacientes com dor torácica

Segalla,

Santos,

Reis

et al. 2023

Rev. Gaúcha Enferm.

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RESUMO Objetivo: Verificar os fatores determinantes de alta prioridade na classificação de risco e os desfechos deste atendimento realizado a pacientes adultos com dor torácica. Método: Estudo retrospectivo, realizado em pronto-socorro referenciado, de hospital público do interior de São Paulo, analisando-se os registros dos atendimentos realizados na classificação de risco em181 prontuários de pacientes com o sintoma dor torácica, no período de agosto a novembro de 2020. Resultados: Prevaleceram indivíduos do sexo masculino 98 (54,1%), com dor moderada 133 (73,5%), alta prioridade de atendimento 135(74,5%,) e que procuraram o serviço espontaneamente 139 (76,8%). Dos classificados em alta prioridade, 47 (34,8%) foram encaminhados para sala de emergência, e destes 27(17,0%) permaneceram internados. Sexo feminino (p=0,0198; OR=0,40; IC=0,189-0866) associou-se ao atendimento prioritário. Conclusão: Apesar da classificação prioritária, poucos participantes foram encaminhados à sala de emergência e evoluíram com necessidade de internação hospitalar. Sexo feminino foi fator protetor para classificação em alta prioridade de atendimento.

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Risk Stratification in Chest Pain: Impact on the Diagnosis of Acute Coronary Syndrome

Cited by 3 publications

References 15 publications

Impact of Care Interventions on the Survival of Patients with Cardiac Chest Pain

Impact of Care Interventions on the Survival of Patients with Cardiac Chest Pain

Determining factors of service priority in the risk classification of patients with chest pain

Fatores determinantes de prioridade de atendimento na classificação de risco a pacientes com dor torácica

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