| Sensitivity and specificity of the Manchester Triage System for patients with acute coronary syndrome. | |
| | |
MedLine Citation:
|
PMID: 20964109 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: Monitoring the performance of triage systems is essential to optimize their usefulness in each hospital. The objective of this study was to assess the sensitivity of the Manchester Triage System in assigning high priority to patients with acute coronary syndrome, and the sensitivity and specificity of the combinations of flowcharts and discriminators routinely used for triage in the Emergency Department of Hospital de S. João, Porto. METHODS: We analyzed a systematic sample of one third of emergency department episodes in 2007, corresponding to 53,039 episodes, of which 307 were cases of acute coronary syndrome. For each episode, we considered the final diagnosis by the Emergency Department attending physician, which was confirmed in 95% of cases. The combinations of flowchart and discriminators suggestive of acute coronary syndrome were defined, based on typical symptoms, including precordial chest pain with or without radiation and/or syncope. RESULTS: The sensitivity of the Manchester Triage System in assigning high priority (immediate--red, or very urgent--orange) to patients with acute coronary syndrome was 87.3% (95% confidence interval [CI]: 83.1-90.6). The proportion of false negatives was higher in extreme age-groups. The sensitivity of combinations of flowchart and discriminators suggestive of acute coronary syndrome was 74.3% (95% CI: 69.1-78.8), lower in women (67.3% vs. 77.7%), and the specificity was 97.4% (95% CI: 97.2-97.5). The likelihood ratio of combinations of flowchart and discriminators suggestive of acute coronary syndrome was 28.3 (95% CI: 26.0-30.8) and that of other combinations was 0.26 (95% CI: 0.22-0.32), less informative in ruling out acute coronary syndrome in women (0.33 vs. 0.23). DISCUSSION: The main limitations of this study derive from the impossibility of including only patients who came directly to this Emergency Department and of testing the validity of the final diagnosis when acute coronary syndrome was not identified in the Emergency Department. However, using electronic data records completed as a matter of routine enabled analysis of a large database, which reflects the practical value of the Manchester Triage System in this context, and most cases identified as acute coronary syndrome were confirmed. CONCLUSIONS: The Manchester Triage System has a high sensitivity in assigning high priority (immediate/very urgent) to patients with acute coronary syndrome. The combinations of flowchart and discriminators defined as suggestive of acute coronary syndrome have very high specificity and moderate sensitivity, but the system has the potential to become more sensitive with no loss in specificity. |
| | |
Authors:
|
David Pinto; Nuno Lunet; Ana Azevedo |
Related Documents
:
|
11301769 - Deep vein thrombosis and air travel. 9199689 - Inadvertent intraoperative myelography with hypaque: case report and discussion. 16488409 - Effects of co-administration of a selective serotonin reuptake inhibitor and monoamine ... 931329 - Effects of excess vitamin a on the cranial neural crest in the chick embryo. 21404219 - Central serous chorioretinopathy as a presenting symptom of endogenous cushing syndrome... 7956179 - Obsessive characteristics in subjects with tourette's syndrome are related to symptoms ... 17506099 - A newly recognized craniosynostosis syndrome with features of aarskog-scott and teebi s... 8033209 - Fmr1 knockout mice: a model to study fragile x mental retardation. the dutch-belgian fr... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology Volume: 29 ISSN: 0870-2551 ISO Abbreviation: Rev Port Cardiol Publication Date: 2010 Jun |
Date Detail:
|
Created Date: 2010-10-22 Completed Date: 2010-11-29 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8710716 Medline TA: Rev Port Cardiol Country: Portugal |
Other Details:
|
Languages: eng; por Pagination: 961-87 Citation Subset: IM |
Affiliation:
|
Serviço de Higiene e Epidemiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acute Coronary Syndrome
/
diagnosis* Adolescent Adult Aged Aged, 80 and over Female Humans Male Middle Aged Sensitivity and Specificity Triage / standards* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Acute coronary syndrome in young adults.
Next Document: Coronary artery bypass grafting in octogenarians: long-term results.