Frequency and clinical correlates of changes in Thrombolysis In Myocardial Infarction risk score during observation period at emergency department in "low-risk" patients with acute chest pain

The American Journal of Cardiology
Francesco PellicciaPietro Tanzi

Abstract

Among 4,333 patients who were triaged in the emergency department (ED) over a 1-year period in 2003 because of acute chest pain, 1,747 (40%) were stratified as "low risk" on the basis of a Thrombolysis In Myocardial Infarction (TIMI) risk score of 0 to 2. Results showed that, during ED stay, TIMI risk score increased to > or =3 in 63% of patients and that such patients were more likely to be diabetic, hypertensive, hyperlipidemic, and smokers, and to have had previous myocardial infarction or revascularization. Patients with changes in TIMI risk score were admitted more often to the hospital, whereas more patients with unchanged TIMI risk score were discharged home directly from the ED. In conclusion, TIMI risk score may change soon after arrival to the ED in 50% of patients with acute chest pain who are initially triaged as low risk. Changes in TIMI risk score are more common in patients with multiple risk factors and/or previous diagnosis of coronary artery disease. Serial, frequent assessments of TIMI score during the ED observation period are mandatory, particularly in these subsets of patients.

References

Aug 11, 2000·JAMA : the Journal of the American Medical Association·E M AntmanE Braunwald
Jul 28, 2005·Annals of Emergency Medicine·W Brian GiblerUNKNOWN Society of Chest Pain Centers

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Citations

Jun 10, 2010·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Erik P HessIan G Stiell
Jun 17, 2011·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Emily C EspositoChristopher J Lindsell
Oct 16, 2016·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·M Fernanda BellolioErik P Hess
Jul 31, 2013·Critical Pathways in Cardiology·Jean ChavezAlexander T Limkakeng

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