![]() ![]() Risk stratification of ED chest pain patients has been extensively studied in recent years ( 3). It is essential to quickly and accurately identify patients who are at high and low risk of developing major adverse cardiac events (MACE) in order to optimally allocate ED and hospital resources. Therefore, distinguishing acute coronary syndrome (ACS) from other cardiac and non-cardiac diseases is crucial ( 3). It is however, not feasible to admit all chest pain patients due to limited healthcare resources ( 2). Many chest pain patients are admitted to the hospital due to the possibility of life threatening conditions, such as acute myocardial infarction (AMI) ( 1). Received: 10 January 2018 Accepted: 19 January 2018 Published: 07 February 2018.Ĭhest pain is a common presenting symptom in the emergency department (ED). Keywords: Clinical score risk stratification chest pain emergency department (ED) systematic review This could potentially be useful in accelerating existing chest pain protocols in the ED setting. Most HRV-based scoring methods had comparable performance to the HEART score while benefiting from faster score calculation without a need for laboratory testing. We found that the HEART score was generally the top performer in identifying chest pain patients at high or low risk of developing MACE. Among the various risk scores, the HEART, TIMI, GRACE, and heart rate variability (HRV)-based scores were the most widely implemented and discussed. The articles covered studies from over 20 countries, where more than 20 different risk scores and scoring methods were investigated. We retrieved a total of 514 articles from both databases and included 29 studies in this systematic review. Two independent reviewers screened the titles, abstracts, and full articles for the inclusion of studies. Systematic reviews, meta-analyses, case reports, and letters to the editor were excluded. Studies were eligible for inclusion if the reported clinical scores were used for risk stratifying ED chest pain patients. Our search was limited to articles published between 01 January 2012 and 25 September 2017. We conducted a search of the literature in online databases PubMed and Embase. This systematic review aims to provide an up-to-date summary of the latest studies on clinical scores for risk stratification of chest pain patients presenting to the ED. Over the years, many risk stratification tools have been developed, among which, the History, Electrocardiogram (ECG), Age, Risk factors, and initial Troponin (HEART), Thrombolysis in Myocardial Infarction (TIMI), and Global Registry of Acute Coronary Events (GRACE) scores are the most widely used. Therefore, it is crucial to stratify chest pain patients based on risk for development of major adverse cardiac events (MACE) in order to provide effective care and prevent overutilization of resources. The etiology of chest pain can range from benign to life threatening causes. Policy of Dealing with Allegations of Research MisconductĪbstract: Chest pain is among the most common complaint presenting to the emergency departments (EDs) worldwide.Policy of Screening for Plagiarism Process. ![]()
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