[Diagnosis, clinical presentation and triage criteria of emergency patients admitted for chest pain: prospective study of 278 cases].
A prospective study of the clinical findings and transfer decision in 278 patients admitted to the emergency ward for chest pain showed that a combination of 115 clinical and ECG data makes it possible to predict 86% of acute myocardial infarctions and unstable angina (specificity 76%). However, the diagnosis of the emergency medical team was adequate in 91% of cases, yielding a 5% rate of unjustified admissions to the intensive care unit. Therefore, the utility of a decision algorithm based upon clinical and ECG data, as proposed by American authors, is questionable. Finally, the indication for transfer to the intensive care unit was not followed in a quarter of patients due to old age and/or associated diseases.
Buclin
T
T
Département de médecine interne, Centre hospitalier universitaire vaudois, Lausanne.
Van Melle
G
G
Haller
E
E
Yersin
B
B
Berger
J P
JP
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000787:Angina Pectoris / Q000175:diagnosis*; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D011446:Prospective Studies; D014218:Triage
Diagnostic, présentation clinique et critères de triage des patients admis en urgence pour douleurs thoraciques: étude prospective de 278 cas.