Buclin T, Van Melle G, Haller E, Yersin B, Berger J P
Département de médecine interne, Centre hospitalier universitaire vaudois, Lausanne.
Schweiz Med Wochenschr. 1988 Dec 17;118(50):1921-5.
A prospective study of the clinical findings and transfer decision in 278 patients admitted to the emergency ward for chest pain showed that a combination of 115 clinical and ECG data makes it possible to predict 86% of acute myocardial infarctions and unstable angina (specificity 76%). However, the diagnosis of the emergency medical team was adequate in 91% of cases, yielding a 5% rate of unjustified admissions to the intensive care unit. Therefore, the utility of a decision algorithm based upon clinical and ECG data, as proposed by American authors, is questionable. Finally, the indication for transfer to the intensive care unit was not followed in a quarter of patients due to old age and/or associated diseases.
一项针对278名因胸痛入住急诊病房患者的临床发现及转运决策的前瞻性研究表明，115项临床和心电图数据相结合能够预测86%的急性心肌梗死和不稳定型心绞痛（特异性为76%）。然而，急诊医疗队在91%的病例中诊断正确，重症监护病房不合理收治率为5%。因此，美国作者提出的基于临床和心电图数据的决策算法的实用性值得怀疑。最后，由于年龄较大和/或存在相关疾病，四分之一的患者未遵循转入重症监护病房的指征。
