30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population

Abstract Background Chest pain remains one of the most challenging serious complaints in the emergency department (ED). A prompt and accurate risk stratification tool for chest pain patients is paramount to help physcian effectively progrnosticate outcomes. HEART score is considered one of the best...

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Autores principales:	Mohamed Hassene Khalil, Adel Sekma, Hajer Yaakoubi, Khaoula Bel Haj Ali, Mohamed Amine Msolli, Kaouthar Beltaief, Mohamed Habib Grissa, Hamdi Boubaker, Mohamed Sassi, Hamadi Chouchene, Youssef Hassen, Houda Ben Soltane, Zied Mezgar, Riadh Boukef, Wahid Bouida, Semir Nouira
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Chest pain Severity of illness index Myocardial infarction Admission avoidance Emergency service Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/ded39a20d81948d2a791b72697b4a129
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spelling	oai:doaj.org-article:ded39a20d81948d2a791b72697b4a1292021-11-21T12:04:15Z30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population10.1186/s12872-021-02381-z1471-2261https://doaj.org/article/ded39a20d81948d2a791b72697b4a1292021-11-01T00:00:00Zhttps://doi.org/10.1186/s12872-021-02381-zhttps://doaj.org/toc/1471-2261Abstract Background Chest pain remains one of the most challenging serious complaints in the emergency department (ED). A prompt and accurate risk stratification tool for chest pain patients is paramount to help physcian effectively progrnosticate outcomes. HEART score is considered one of the best scores for chest pain risk stratification. However, most validation studies of HEART score were not performed in populations different from those included in the original one. Objective To validate HEART score as a prognostication tool, among Tunisian ED patients with undifferentiated chest pain. Methods Our prospective, multicenter study enrolled adult patients presenting with chest pain at chest pain units. Patients over 30 years of age with a primary complaint of chest pain were enrolled. HEART score was calculated for every patient. The primary outcome was major cardiovascular events (MACE) occurrence, including all-cause mortality, non-fatal myocardial infarction (MI), and coronary revascularisation over 30 days following the ED visit. The discriminative power of HEART score was evaluated by the area under the ROC curve. A calibration analysis of the HEART score in this population was performed using Hosmer–Lemeshow goodness of test. Results We enrolled 3880 patients (age 56.3; 59.5% males). The application of HEART score showed that most patients were in intermediate risk category (55.3%). Within 30 days of ED visit, MACE were reported in 628 (16.2%) patients, with an incidence of 1.2% in the low risk group, 10.8% in the intermediate risk group and 62.4% in the high risk group. The area under receiver operating characteristic curve was 0.87 (95% CI 0.85–0.88). HEART score was not well calibrated (χ 2 statistic = 12.34; p = 0.03). Conclusion HEART score showed a good discrimination performance in predicting MACE occurrence at 30 days for Tunisian patients with undifferentiated acute chest pain. Heart score was not well calibrated in our population.Mohamed Hassene KhalilAdel SekmaHajer YaakoubiKhaoula Bel Haj AliMohamed Amine MsolliKaouthar BeltaiefMohamed Habib GrissaHamdi BoubakerMohamed SassiHamadi ChoucheneYoussef HassenHouda Ben SoltaneZied MezgarRiadh BoukefWahid BouidaSemir NouiraBMCarticleChest painSeverity of illness indexMyocardial infarctionAdmission avoidanceEmergency serviceDiseases of the circulatory (Cardiovascular) systemRC666-701ENBMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Chest pain Severity of illness index Myocardial infarction Admission avoidance Emergency service Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Chest pain Severity of illness index Myocardial infarction Admission avoidance Emergency service Diseases of the circulatory (Cardiovascular) system RC666-701 Mohamed Hassene Khalil Adel Sekma Hajer Yaakoubi Khaoula Bel Haj Ali Mohamed Amine Msolli Kaouthar Beltaief Mohamed Habib Grissa Hamdi Boubaker Mohamed Sassi Hamadi Chouchene Youssef Hassen Houda Ben Soltane Zied Mezgar Riadh Boukef Wahid Bouida Semir Nouira 30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population
description	Abstract Background Chest pain remains one of the most challenging serious complaints in the emergency department (ED). A prompt and accurate risk stratification tool for chest pain patients is paramount to help physcian effectively progrnosticate outcomes. HEART score is considered one of the best scores for chest pain risk stratification. However, most validation studies of HEART score were not performed in populations different from those included in the original one. Objective To validate HEART score as a prognostication tool, among Tunisian ED patients with undifferentiated chest pain. Methods Our prospective, multicenter study enrolled adult patients presenting with chest pain at chest pain units. Patients over 30 years of age with a primary complaint of chest pain were enrolled. HEART score was calculated for every patient. The primary outcome was major cardiovascular events (MACE) occurrence, including all-cause mortality, non-fatal myocardial infarction (MI), and coronary revascularisation over 30 days following the ED visit. The discriminative power of HEART score was evaluated by the area under the ROC curve. A calibration analysis of the HEART score in this population was performed using Hosmer–Lemeshow goodness of test. Results We enrolled 3880 patients (age 56.3; 59.5% males). The application of HEART score showed that most patients were in intermediate risk category (55.3%). Within 30 days of ED visit, MACE were reported in 628 (16.2%) patients, with an incidence of 1.2% in the low risk group, 10.8% in the intermediate risk group and 62.4% in the high risk group. The area under receiver operating characteristic curve was 0.87 (95% CI 0.85–0.88). HEART score was not well calibrated (χ 2 statistic = 12.34; p = 0.03). Conclusion HEART score showed a good discrimination performance in predicting MACE occurrence at 30 days for Tunisian patients with undifferentiated acute chest pain. Heart score was not well calibrated in our population.
format	article
author	Mohamed Hassene Khalil Adel Sekma Hajer Yaakoubi Khaoula Bel Haj Ali Mohamed Amine Msolli Kaouthar Beltaief Mohamed Habib Grissa Hamdi Boubaker Mohamed Sassi Hamadi Chouchene Youssef Hassen Houda Ben Soltane Zied Mezgar Riadh Boukef Wahid Bouida Semir Nouira
author_facet	Mohamed Hassene Khalil Adel Sekma Hajer Yaakoubi Khaoula Bel Haj Ali Mohamed Amine Msolli Kaouthar Beltaief Mohamed Habib Grissa Hamdi Boubaker Mohamed Sassi Hamadi Chouchene Youssef Hassen Houda Ben Soltane Zied Mezgar Riadh Boukef Wahid Bouida Semir Nouira
author_sort	Mohamed Hassene Khalil
title	30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population
title_short	30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population
title_full	30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population
title_fullStr	30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population
title_full_unstemmed	30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population
title_sort	30 day predicted outcome in undifferentiated chest pain: multicenter validation of the heart score in tunisian population
publisher	BMC
publishDate	2021
url	https://doaj.org/article/ded39a20d81948d2a791b72697b4a129
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30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population

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