Department of Emergency Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Department of Emergency Medicine, Department of Implementation Science, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Rev Cardiovasc Med. 2021 Dec 22;22(4):1393-1403. doi: 10.31083/j.rcm2204144.
Acute chest pain is a common emergency department (ED) chief complaint. Evaluating patients for acute coronary syndrome is challenging because missing the diagnosis carries substantial morbidity, mortality, and medicolegal consequences. However, over-testing is associated with increased cost, overcrowding, and possible iatrogenic harm. Over the past two decades, multiple risk scoring systems have been developed to help emergency providers evaluate patients with acute chest pain. The ideal risk score balances safety by achieving high sensitivity and negative predictive value for major adverse cardiovascular events while also being effective in identifying a large proportion of patients for early discharge from the ED. This review examines contemporary risk scores used to risk stratify patients with acute chest pain.
急性胸痛是急诊科常见的主要主诉。评估急性冠状动脉综合征患者具有挑战性，因为漏诊会带来大量的发病率、死亡率和医疗法律后果。然而，过度检测与成本增加、过度拥挤和可能的医源性伤害有关。在过去的二十年中，已经开发出多种风险评分系统来帮助急诊提供者评估急性胸痛患者。理想的风险评分通过实现对主要不良心血管事件的高灵敏度和阴性预测值来平衡安全性，同时也能有效地识别出大部分患者，以便从急诊科早期出院。本综述检查了用于对急性胸痛患者进行风险分层的当代风险评分。
