Document Detail


External Validation of the GRACE Freedom from Events Score.
MedLine Citation:
PMID:  22710146     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: Acute coronary syndrome (ACS) is a common life-threatening condition but the majority of patients are at low risk of acute adverse events. In 2005, the GRACE Freedom-from-Event score (GFFES) was developed to identify patients with a low risk of adverse in-hospital events. Our aim was to externally validate this score. METHODS: A prospective observational cohort of patients was admitted to a cardiology service with admission diagnoses of chest pain, unstable angina or myocardial infarction (MI). Clinical and investigational data were collected. Defined major adverse cardiac events (MACE) were death, new MI, stroke, acute pulmonary oedema, cardiac arrest or sustained ventricular tachycardia, high degree atrioventricular block, cardiogenic shock, pacemaker or intra-aortic balloon pump insertion, assisted ventilation or new acute renal failure occurring during the index admission. The primary outcome of interest was the predictive performance of the GFFES for MACE, by ROC curve and clinical performance analysis. RESULTS: 238 patients were studied; median age 67, 56.7% were male. Seventy-eight patients (32.8%) were classified as low risk by the score (GFFES score≥287). There were no MACE in the low risk group. The AUC for predictive performance of the GFFES was 0.74 (95% CI 0.62-0.86). Sensitivity was 100% (95% CI 71.7-100%), specificity 34.7% (95% CI 28.5-41.3%) and negative predictive value 100% (95% CI 94.2-100%). CONCLUSION: In this single site prospective validation, GFFES showed good discrimination, sensitivity and negative predictive value. It may be a useful tool for assigning patients to appropriate levels of care based on risk.
Authors:
Anne-Maree Kelly; Prashant Dabee; Sharon Klim; Kean Soon
Related Documents :
11175176 - Tissue doppler echocardiography: historical perspective and technological considerations.
10994936 - Intravascular physiologic evaluation of the left anterior small thoracotomy operation: ...
20582886 - pulse-wave doppler tissue imaging in the assessment of regional left ventricular diasto...
16774986 - Sustained improvement in left ventricular diastolic function after alcohol septal ablat...
8466346 - Improvement of cardiac function impaired by repeated ischemic arrests in isolated rat h...
16004886 - Elevated level of plasma homocysteine in patients with slow coronary flow.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-16
Journal Detail:
Title:  Heart, lung & circulation     Volume:  -     ISSN:  1444-2892     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963739     Medline TA:  Heart Lung Circ     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.
Affiliation:
Joseph Epstein Centre for Emergency Medicine at Western Health, Australia; The University of Melbourne, Australia.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Complement factor I deficiency: a not so rare immune defect: characterization of new mutations and t...
Next Document:  Nocturnal Hypoxemia But Not Hypercapnia Correlates With Sleep Quality in Children.