| Prognostic value of the Duke treadmill score for emergency department patients with chest pain. | |
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MedLine Citation:
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PMID: 19062225 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Alex F Manini; Andrew T McAfee; Vicki E Noble; J Stephen Bohan |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't Date: 2008-12-04 |
Journal Detail:
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Title: The Journal of emergency medicine Volume: 39 ISSN: 0736-4679 ISO Abbreviation: J Emerg Med Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-09 Completed Date: 2010-11-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8412174 Medline TA: J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 135-43 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Harvard Affiliated Emergency Medicine Residency, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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