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External validation of an acute chest pain triage assessment model: A prospective observational study
Xuan Zhou1, Gangren Jian2, Yuefang He3
1The School of Nursing, Fujian Medical University, Fuzhou, Fujian, China; Putian Health School, Putian, Fujian, China.
Background:
We aimed to externally validate and modify the acute chest pain triage assessment model in the emergency department, for identifying high-risk patients and exploring the interrelationships with triage criteria, to guide medical staff to quickly and effectively triage and grade patients with chest pain.
Methods:
In a prospective observational study, a total of 316 patients with chest pain were included, and the performance of the modified acute chest pain triage assessment model was compared with the original model, HEART Pathway, EDACS, and the commonly used scores for critically ill patients (MEWS, NEWS). The goodness of fit and discrimination were assessed for model performances.
Results:
Our model is significantly better than original model, HEART Pathway, EDACS, MEWS, NEWS, AUC was 0.859 (95 %CI: 0.818-0.901), 0.736 (95 %CI: 0.679-0.793), 0.766 (95 %CI:0.714-0.818), 0.654 (95 %CI: 0.593-0.715), 0.585 (95 %CI: 0.529-0.640), 0.583 (95 %CI: 0.524-0.642). Regarding the exploration of graded scoring, the modified model still lacks significant stratification effects on the subdivision of high-risk patients. It demonstrates better score stratification effects compared to other assessment tools.
Conclusion:
We have optimized a simple and fast evaluation tool, which will be determined by the grading and classification score threshold, providing substantial support for its application as an emergency department decision tool.
Registration:
The study protocol was approved by the Ethics Committee Board of Fujian Provincial Hospital.
Clinical Trial Registration Number:
ChiCTR2200061918.
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