Background: The implementation of institutional protocols in the emergency department (ED) for risk stratification in patients with chest pain has been recommended. Objective: To assess the sensitivity, specificity and predictive value of an institutional risk stratification protocol for chest pain suggestive of acute coronary syndrome (ACS). Method: Cross-sectional study conducted based on the computerized records of patients treated with the use of a chest pain protocol adapted from the Manchester protocol. The level of risk was stratified by applying five colors representing the respective levels. Each color represents a level of severity and a maximum waiting time for receiving medical care. Red and orange were considered to be high priority, while patients with yellow, green or blue indications were considered to represent a low priority. To compare the type of diagnosis and the classification of priority for receiving care, the Pearson's chi-square test was used, considering a significance level of p< 0.05 for all tests. Results: The records of 1,074 patients admitted to the cardiology ED were analyzed. Men (54%), with a mean age of 60 ± 15 years, with complaints of chest pain (44%) of moderate intensity (80%) were predominant the study. Of these patients, 19% were classified as high priority, while 81% were considered to represent a low priority. ACS was confirmed in 23% of the patients, with 34% of them being classified as high priority and 66% as low priority. The sensitivity of the risk stratification protocol for chest pain was 33.7% and the specificity was 86.0%, with a positive and negative predictive value of 41.7% and 81.3%, respectively. Conclusion: The Institutional risk stratification protocol for chest pain suggestive of ACS presented satisfactory specificity and a low degree of sensitivity. (Int J Cardiovasc Sci. 2021; 34(1):67-73)
CITATION STYLE
Reis, A. P. P., Ruschel, K. B., de Moraes, M. A. P., Belli, K., Saffi, M. L., & Fagundes, J. E. (2021). Risk Stratification in Chest Pain: Impact on the Diagnosis of Acute Coronary Syndrome. International Journal of Cardiovascular Sciences, 34(1), 67–73. https://doi.org/10.36660/ijcs.20190178
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