Key result
The HEART score demonstrated an 87% classification accuracy for hospital admission and moderate accuracy (AUC 0.66-0.78) for predicting emergent cardiac imaging results, 30-day readmissions, and 30-day MACE, with no significant differences across White, Black, and Hispanic patients.
Why the study?
The study aimed to examine the role of the HEART score in evaluating clinical outcomes among emergency department patients across different ethnicities.
Does the HEART score accurately predict clinical outcomes and hospital admissions in emergency department patients with chest pain across different ethnicities?
Observational (n=8,899)
No
Does the HEART score accurately predict clinical outcomes and hospital admissions in emergency department patients with chest pain across different ethnicities?
Effect estimate: AUC 0.66-0.78
The HEART score is a valid tool for risk-stratifying ED patients with chest pain, demonstrating consistent predictive accuracy for 30-day MACE and hospital readmissions across White, Black, and Hispanic populations without evidence of racial disparity.
OBJECTIVE: We aimed to examine the role of the HEART (history, EKG, age, risk factors, and troponin) score in the evaluation of six clinical outcomes among three groups of patients in the emergency department (ED). METHODS: We performed a retrospective observational study among three ED patient groups including White, Black, and Hispanic patients. ED providers used the HEART score to assess the need for patient hospital admission and for emergent cardiac imaging tests (CITs). HEART scores were measured using classification accuracy rates. Performance accuracies were measured in terms of HEART score in relation to four clinical outcomes (positive findings of CITs, ED returns, hospital readmissions, and 30-day major adverse cardiac events [MACE]). RESULTS: A high classification accuracy rate (87%) was found for use of the HEART score to determine hospital admission. HEART scores showed moderate accuracy (area under the receiver operating characteristic curve 0.66-0.78) in predicting results of emergent CITs, 30-day hospital readmissions, and 30-day MACE outcomes. CONCLUSIONS: Providers adhered to use of the HEART score to determine hospital admission. The HEART score may be associated with emergent CIT findings, 30-day hospital readmissions, and 30-day MACE outcomes, with no differences among White, Black, and Hispanic patient populations.
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Meyering et al. (2021) conducted an observational in Chest pain (n=8,899). HEART score was evaluated on Prediction of emergent cardiac imaging test results, 30-day hospital readmissions, and 30-day MACE outcomes (AUC 0.66-0.78). The HEART score demonstrated an 87% classification accuracy for hospital admission and moderate accuracy (AUC 0.66-0.78) for predicting emergent cardiac imaging results, 30-day readmissions, and 30-day MACE, with no significant differences across White, Black, and Hispanic patients.
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