A study of nontraumatic acute chest pain risk stratification in emergency department / 中华急诊医学杂志

ABSTRACT

ObjectiveTo investigate the independent risk factors of 30-day mortality of nontraumatic acute chest pain in emergency department so as to get non - traumatic acute chest pain risk score,MethodsThe clinical data of 532 patients with non - traumatic acute chest pain were reviewed.The independent risk factors of 30 - day mortality were identified after analysis of medical history,symptom and sign,laboratory findings by uuivariate analysis and logistic regression.Non- traumatic acute chest pain risk score was made as per the odds ratios of these risk factors. ResultsThe average age of the patients was (55.7 + 12.7 ) years,and 45 patients ( 8.4％ ) died after 30 days.In patients with non - traumatic acute chest pain,history of hypertension (OR4.28; 95％ CI1.59-11.55 ),prolonged chest pain (OR1.1; 95％ CI1.05-1.15),dyspnea (OR6.61; 95％CI2.40-18.10) and tachycardia (OR1.02; 95％CI1.00-1.04),high leucocyte count (OR1.18; 95％CI1.06-1.31) and D - Dimer ( OR1.002; 95％ CI1.001-1.002 ) predicted 30 - day mortality independently,whereas chest pain relieved by medicine (OR0. 15; 95％ CI0.04-0.65),high blood oxygen saturation (SaO2) (OR0.89; 95％CI0.83-0.98) and normal hematocrit (OR0.92; 95％CI0.86-0.99) were good markers to predict optimistic prognosis.Non - traumatic acute chest pain risk score was higher in 30 - day dead group than those in survival group significantly ( P ＜ 0.01 ),and mortality was significantly different between groups with various risk stratification (P ＜ 0. 01 ).Conclusions Clinical physician can predict 30 - day mortality and evaluate prognosis in patients with acute chest pain by using non - traumatic acute chest pain risk score quickly and effectively.