Document Detail


Prognostic value of the Duke treadmill score for emergency department patients with chest pain.
MedLine Citation:
PMID:  19062225     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The potential clinical utility of the Duke Treadmill Score (DTS) in the Emergency Department (ED) to risk-stratify patients with chest pain but negative cardiac biomarkers and non-diagnostic electrocardiograms is unclear.
OBJECTIVE: We evaluated whether DTS was associated with 30-day adverse cardiac outcomes for low-risk ED patients with chest pain.
METHODS: For this prospective, observational cohort study, the primary outcome was any of the following at 30 days: cardiac death, myocardial infarction, or coronary revascularization. DTS risk categories (low, intermediate, high) were compared with 30-day cardiac outcomes.
RESULTS: We enrolled 191 patients, of whom 20 (10%) were lost to follow-up, leaving 171 patients (mean age 53.3 +/- 12.4 years, 54% female, 3.5% adverse event rate) for evaluation. Sensitivity and specificity of DTS for 30-day events were 83.3% and 71.5%, respectively, with a 99.2% negative predictive value (confidence interval 95.4-99.9) for 30-day event-free survival.
CONCLUSIONS: In this cohort of low-risk ED patients with chest pain, DTS demonstrated excellent negative predictive value for 30-day event-free survival and facilitated safe disposition of a large subset of patients.
Authors:
Alex F Manini; Andrew T McAfee; Vicki E Noble; J Stephen Bohan
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-12-04
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  39     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-09     Completed Date:  2010-11-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  135-43     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Harvard Affiliated Emergency Medicine Residency, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Markers / blood
Chest Pain*
Creatine Kinase, MB Form / blood
Electrocardiography
Emergency Service, Hospital
Exercise Test*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Ischemia / blood,  diagnosis*
Odds Ratio
Predictive Value of Tests
Prospective Studies
Troponin I / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin I; EC 2.7.3.2/Creatine Kinase, MB Form

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


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