Key result
The modified TIMI score performed better than the standard TIMI score for predicting 30-day death, MI, or revascularization (AUC 0.80 vs 0.71, p<0.001), but neither was sufficiently sensitive.
Why the study?
Does the modified TIMI score improve risk stratification compared to the standard TIMI score in emergency department patients with suspected ACS?
Population
1666 emergency department patients undergoing assessment for possible acute coronary syndrome (ACS)
Comparison
Modified TIMI score (mTIMI, range 0-10) vs Standard TIMI score (range 0-7)
Design
Cohort
Follow-up
30 days
Authors
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Neither score is sensitive enough for safe early discharge; hypothesis-generating for modified TIMI validation in ED chest pain.
Observational (n=1,666)
Yes
Does the modified TIMI score improve risk stratification compared to the standard TIMI score in emergency department patients with suspected ACS?
Effect estimate: AUC 0.80 vs 0.71 (95% CI 0.76 to 0.83)
p-value: p=<0.001
The modified TIMI score performs better than the standard TIMI score for ED risk stratification of chest pain, but neither is sufficiently sensitive at scores >0 to allow safe early discharge without further investigation.
Macdonald et al. (2013) conducted an observational in suspected acute coronary syndrome (ACS) (n=1,666). Modified TIMI score (mTIMI) vs. Standard TIMI score was evaluated on Composite of all-cause death, myocardial infarction or coronary revascularisation within 30 days (AUC 0.80 vs 0.71, 95% CI 0.76 to 0.83, p=<0.001). The modified TIMI score performed better than the standard TIMI score for predicting 30-day death, MI, or revascularization (AUC 0.80 vs 0.71, p<0.001), but neither was sufficiently sensitive.
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