Why the study?
Evaluating patients presenting to the emergency department with acute chest pain is challenging, balancing the risks of missing acute coronary syndrome against the costs and harms of over-testing.
This review summarizes contemporary risk scores used to stratify patients with acute chest pain in the emergency department to balance safety and early discharge.
Multiple chest pain risk scores aid ED evaluation; leaves open optimal selection balancing missed ACS against over-testing.
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.
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Ashburn et al. (2021) studied this question.
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