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논문 기본 정보

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저자정보
Nicola Parenti (Emergency Department University Hospital of Modena Modena Italy) Giuseppe Lippi (Section of Clinical Biochemistry University of Verona) Maria Letizia Bacchi Reggiani (Emergency Department University of Bologna Bologna Italy) Antonio Luciani (Emergency Department University Hospital of Modena Modena Italy) Mario Cavazza (Emergency Department University of Bologna Bologna Italy) Antonello Pietrangelo (Internal Department University Hospital of Modena Modena Italy) Alberto Vegetti (Internal Department University Hospital of Modena Modena Italy) Lucio Brugioni (Emergency Department University Hospital of Modena Modena Italy) Laura Bonfanti (Emergency Department University Hospital of Parma) Gianfranco Cervellin (Academic Hospital of Parma)
저널정보
대한응급의학회 Clinical and Experimental Emergency Medicine Clinical and Experimental Emergency Medicine Vol.6 No.3
발행연도
2019.1
수록면
212 - 217 (6page)

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Objective To rapidly and safely identify the risk of developing acute coronary syndrome in patients with chest pain who present to the emergency department, the clinical use of the History, Electrocardiogram, Age, Risk Factors, and Troponin (HEART) scoring has recently been proposed. This study aimed to assess the inter-rater reliability of the HEART score calculated by a large number of Italian emergency physicians. Methods The study was conducted in three academic emergency departments using clinical scenarios obtained from medical records of patients with chest pain. Twenty physicians, who took the HEART score course, independently assigned a score to different clinical scenarios, which were randomly administered to the participants, and data were collected and recorded in a spreadsheet by an independent investigator who was blinded to the study’s aim. Results After applying the exclusion criteria, 53 scenarios were finally included in the analysis. The general inter-rater reliability was good (kappa statistics [κ], 0.63; 95% confidence interval, 0.57 to 0.70), and a good inter-rater agreement for the high- and low-risk classes (HEART score, 7 to 10 and 0 to 3, respectively; κ, 0.60 to 0.73) was observed, whereas a moderate agreement was found for the intermediate-risk class (HEART score, 4 to 6; κ, 0.51). Among the different items of the HEART score, history and electrocardiogram had the worse agreement (κ, 0.37 and 0.42, respectively). Conclusion The HEART score had good inter-rater reliability, particularly among the high- and low-risk classes. The modest agreement for history suggests that major improvements are needed for objectively assessing this component.
#HEART score #HEART pathway #Chest pain #Acute coronary syndrome #Emergency service #hospital

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참고문헌 (18)

참고문헌 신청
Goodacre S / 2005 / The health care burden of acute chest pain / Heart 91:229~230 google schola Conti A / 2002 / Effectiveness of a multidisciplinary chest pain unit for the assessment of coronary syndromes and risk stratification in the Florence area / Am Heart J 144:630~635 google schola Cervellin G / 2016 / Diagnostic algorithms for acute coronary syndrome-is one better than another? / Ann Transl Med 4:193 google schola Hamm CW / 2011 / ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the task force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC) / Eur Heart J 32:2999~3054 google schola Amsterdam EA / 2010 / Testing of low-risk patients presenting to the emergency department with chest pain: a scientific statement from the American Heart Association / Circulation 122:1756~1776 google schola

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