...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The American journal of emergency medicine >The new Vancouver Chest Pain Rule using troponin as the only biomarker: An external validation study
【24h】

The new Vancouver Chest Pain Rule using troponin as the only biomarker: An external validation study

机译：使用肌钙蛋白作为唯一生物标志物的新温哥华胸痛法则：一项外部验证研究

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Objectives To externally evaluate the accuracy of the new Vancouver Chest Pain Rule and to assess the diagnostic accuracy using either sensitive or highly sensitive troponin assays. Methods Prospectively collected data from 2 emergency departments (EDs) in Australia and New Zealand were analysed. Based on the new Vancouver Chest Pain Rule, low-risk patients were identified using electrocardiogram results, cardiac history, nitrate use, age, pain characteristics and troponin results at 2 hours after presentation. The primary outcome was 30-day diagnosis of acute coronary syndrome (ACS), including acute myocardial infarction, and unstable angina. Sensitivity, specificity, positive predictive values and negative predictive values were calculated to assess the accuracy of the new Vancouver Chest Pain Rule using either sensitive or highly sensitive troponin assay results. Results Of the 1635 patients, 20.4% had an ACS diagnosis at 30 days. Using the highly sensitive troponin assay, 212 (13.0%) patients were eligible for early discharge with 3 patients (1.4%) diagnosed with ACS. Sensitivity was 99.1% (95% CI 97.4-99.7), specificity was 16.1 (95% CI 14.2-18.2), positive predictive values was 23.3 (95% CI 21.1-25.5) and negative predictive values was 98.6 (95% CI 95.9-99.5). The diagnostic accuracy of the rule was similar using the sensitive troponin assay. Conclusions The new Vancouver Chest Pain Rule should be used for the identification of low risk patients presenting to EDs with symptoms of possible ACS, and will reduce the proportion of patients requiring lengthy assessment; however we recommend further outpatient investigation for coronary artery disease in patients identified as low risk.
机译：目的从外部评估新的《温哥华胸痛法则》的准确性，并使用敏感或高度敏感的肌钙蛋白测定评估诊断准确性。方法对澳大利亚和新西兰的两个急诊科（ED）的前瞻性数据进行分析。根据新的《温哥华胸痛法则》，在出院后2小时使用心电图结果，心脏病史，硝酸盐使用，年龄，疼痛特征和肌钙蛋白结果确定低危患者。主要结果是诊断为急性冠状动脉综合征（ACS）的30天，包括急性心肌梗塞和不稳定型心绞痛。计算了敏感性，特异性，阳性预测值和阴性预测值，以使用敏感或高度敏感的肌钙蛋白测定结果评估新的《温哥华胸痛法则》的准确性。结果在1635例患者中，有20.4％在30天时有ACS诊断。使用高度敏感的肌钙蛋白测定，有212例（13.0％）的患者符合早期出院的资格，其中3例（1.4％）被诊断为ACS。敏感性为99.1％（95％CI 97.4-99.7），特异性为16.1（95％CI 14.2-18.2），阳性预测值为23.3（95％CI 21.1-25.5），阴性预测值为98.6（95％CI 95.9- 99.5）。使用敏感的肌钙蛋白测定法，该规则的诊断准确性相似。结论新的《温哥华胸痛法则》应用于识别表现为可能具有ACS症状的ED的低风险患者，并减少需要长时间评估的患者比例;但是，我们建议对确定为低风险的患者进行冠状动脉疾病的进一步门诊检查。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号