Document Detail


Assessment of a creatine kinase-MB/myoglobin kit in the prehospital setting in patients presenting with acute nontraumatic chest pain: the "Shahal" experience.
MedLine Citation:
PMID:  10397209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the usefulness of a novel qualitative, rapid, bedside immunoassay device for the detection of elevated creatine kinase MBmass (CK-MB) and myoglobin as a supportive tool for decision-making by the physician who is evaluating patients who present with chest pain. DESIGN: Prospective study. SETTING: Prehospital (mobile intensive care units). PATIENTS: Three hundred twenty-eight consecutive patients, age 71+/-13 yrs (64% males), who were admitted to the hospital via Shahal's mobile intensive care units. INTERVENTION: During a 6-month period, based on clinical presentations and electrocardiograms, the mobile's physicians classified patients into groups of high or low probability of having an acute myocardial infarction and, thereafter, used a rapid bedside STATus kit (Spectral Diagnostics, Toronto, Ontario, Canada) to determine blood creatine kinase/MB and myoglobin. MEASUREMENTS AND MAIN RESULTS: Myocardial infarction was confirmed in 59 (18%) patients. If measured >2 hrs after onset, diagnostic sensitivities, specificities, and positive and negative predictive values for physicians were as follows: 71%, 90%, 46%, and 96%, respectively, compared with 100%, 85%, 44%, and 100%, respectively, if assessed by the kit. CONCLUSIONS: If used 2 to 12 hrs from the onset of symptoms, this device is a convenient diagnostic aid to prevent a misdiagnosis of acute myocardial infarction or unnecessary hospitalization to exclude infarction. This tool may be a promising cost-cutting factor in these days of escalating expenses and dwindling resources.
Authors:
A Roth; N Malov; Y Bloch; M Golovner; Y Slesarenko; R Naveh; E Kaplinsky; S Laniado
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  27     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-08-05     Completed Date:  1999-08-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1085-9     Citation Subset:  AIM; IM    
Affiliation:
The Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel. roth_a@netvision.net.il
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Ambulances
Chest Pain / etiology
Creatine Kinase / blood*
Electrocardiography
Emergency Medical Services
Female
Humans
Isoenzymes
Male
Middle Aged
Myocardial Infarction / blood,  classification,  diagnosis*
Myoglobin / blood*
Prospective Studies
Reagent Kits, Diagnostic*
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Isoenzymes; 0/Myoglobin; 0/Reagent Kits, Diagnostic; EC 2.7.3.2/Creatine Kinase
Comments/Corrections
Comment In:
Crit Care Med. 1999 Jun;27(6):1035-6   [PMID:  10397190 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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