对急诊室患有昏迷的急诊室患者进行连续素测试的实用性
Cameron W Leafloor1,2,3, Andrew D McRae4, Eric Mercier5,6
1Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
CJEM
|August 2, 2024
概括
在急诊室昏迷患者的连续心脏素测试没有改善诊断或预后. 初始的热素水平足以进行风险分层,连续测试增加了急诊室停留时间.
科学领域:
- 紧急医疗 紧急医疗
- 心脏病学 心脏病学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 心脏素测试在急诊室 (ED) 用于昏迷患者,以识别急性冠状动脉综合征 (ACS) 并预测严重的不良事件.
- 序列激素测试在改善昏迷患者的诊断产量和预后方面的实用性仍然不清楚.
研究的目的:
- 评估连续心脏托罗宁测试是否提高了急诊室患者出现昏迷的诊断准确性和预后能力.
- 为了比较患者在ED停留的时间,患者接受单次和连续的热素测量.
主要方法:
- 对来自两个前性研究的数据进行了二次分析.
- 包括已成年患者 (≥16岁),在ED上出现昏.
- 收集的数据包括患者的特征,生命体征,医生诊断,心电图,热素结果,以及30天的严重不良事件.
主要成果:
- 在4996名患者中,有4397名患者进行了单次热素测量,499名患者进行了连续测量.
- 与单次测量相比,连续激素测试并没有显著改善严重不良事件的检测.
- 连续进行氨酸测试的患者在ED停留时间中位数显著长 (5.6小时 vs 3.8小时).
结论:
- 最初的心脏托罗宁测量足以识别ED的严重不良事件和风险分层.
- 连续素测试不会提高昏迷患者的诊断产量或预后.
- 序列激素检测应保留给患有持续症状或有关心电图发现暗示心脏缺血的患者.
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