title: 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.
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.
authors.affiliation: Department of Cardiology, San Filippo Neri Hospital, Rome, Italy. f.pelliccia@mclink.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Pelliccia
authors.forename: Paolo
authors.initials: P
authors.lastname: Salvini
authors.forename: Domenico
authors.initials: D
authors.lastname: Cartoni
authors.forename: Bruno
authors.initials: B
authors.lastname: Polletta
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pasceri
authors.forename: Christian
authors.initials: C
authors.lastname: Pristipino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Richichi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mercuro
authors.forename: Pietro
authors.initials: P
authors.lastname: Tanzi
mesh_terms: D015415:Biomarkers / Q000032:analysis*; D002637:Chest Pain / Q000097:blood / Q000175:diagnosis*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers