Validation and modification of HEART score components for patients with chest pain in the emergency department
Objective This study aimed to clarify the relative prognostic value of each History, Electrocardiography, Age, Risk Factors, and Troponin (HEART) score component for major adverse cardiac events (MACE) within 3 months and validate the modified HEART (mHEART) score. Methods This study evaluated the H...
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| Format: | Article |
| Language: | English |
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The Korean Society of Emergency Medicine
2021-12-01
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| Series: | Clinical and Experimental Emergency Medicine |
| Subjects: | |
| Online Access: | http://ceemjournal.org/upload/pdf/ceem-20-106.pdf |
| _version_ | 1797897185911635968 |
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| author | Min Jae Kim Sang Ook Ha Young Sun Park Jeong Hyeon Yi Won Seok Yang Jin Hyuck Kim |
| author_facet | Min Jae Kim Sang Ook Ha Young Sun Park Jeong Hyeon Yi Won Seok Yang Jin Hyuck Kim |
| author_sort | Min Jae Kim |
| collection | DOAJ |
| description | Objective This study aimed to clarify the relative prognostic value of each History, Electrocardiography, Age, Risk Factors, and Troponin (HEART) score component for major adverse cardiac events (MACE) within 3 months and validate the modified HEART (mHEART) score. Methods This study evaluated the HEART score components for patients with chest symptoms visiting the emergency department from November 19, 2018 to November 19, 2019. All components were evaluated using logistic regression analysis and the scores for HEART, mHEART, and Thrombolysis in Myocardial Infarction (TIMI) were determined using the receiver operating characteristics curve. Results The patients were divided into a derivation (809 patients) and a validation group (298 patients). In multivariate analysis, age did not show statistical significance in the detection of MACE within 3 months and the mHEART score was calculated after omitting the age component. The areas under the receiver operating characteristics curves for HEART, mHEART and TIMI scores in the prediction of MACE within 3 months were 0.88, 0.91, and 0.83, respectively, in the derivation group; and 0.88, 0.91, and 0.81, respectively, in the validation group. When the cutoff value for each scoring system was determined for the maintenance of a negative predictive value for a MACE rate >99%, the mHEART score showed the highest sensitivity, specificity, positive predictive value, and negative predictive value (97.4%, 54.2%, 23.7%, and 99.3%, respectively). Conclusion Our study showed that the mHEART score better detects short-term MACE in high-risk patients and ensures the safe disposition of low-risk patients than the HEART and TIMI scores. |
| first_indexed | 2024-04-10T07:53:33Z |
| format | Article |
| id | doaj.art-d4ac33a12f4a4011979921926b395ef3 |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:53:33Z |
| publishDate | 2021-12-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-d4ac33a12f4a4011979921926b395ef32023-02-23T07:07:10ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252021-12-018427928810.15441/ceem.20.106362Validation and modification of HEART score components for patients with chest pain in the emergency departmentMin Jae Kim0Sang Ook Ha1Young Sun Park2Jeong Hyeon Yi3Won Seok Yang4Jin Hyuck Kim5 Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang, Korea Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang, Korea Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang, Korea Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang, Korea Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang, Korea Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang, KoreaObjective This study aimed to clarify the relative prognostic value of each History, Electrocardiography, Age, Risk Factors, and Troponin (HEART) score component for major adverse cardiac events (MACE) within 3 months and validate the modified HEART (mHEART) score. Methods This study evaluated the HEART score components for patients with chest symptoms visiting the emergency department from November 19, 2018 to November 19, 2019. All components were evaluated using logistic regression analysis and the scores for HEART, mHEART, and Thrombolysis in Myocardial Infarction (TIMI) were determined using the receiver operating characteristics curve. Results The patients were divided into a derivation (809 patients) and a validation group (298 patients). In multivariate analysis, age did not show statistical significance in the detection of MACE within 3 months and the mHEART score was calculated after omitting the age component. The areas under the receiver operating characteristics curves for HEART, mHEART and TIMI scores in the prediction of MACE within 3 months were 0.88, 0.91, and 0.83, respectively, in the derivation group; and 0.88, 0.91, and 0.81, respectively, in the validation group. When the cutoff value for each scoring system was determined for the maintenance of a negative predictive value for a MACE rate >99%, the mHEART score showed the highest sensitivity, specificity, positive predictive value, and negative predictive value (97.4%, 54.2%, 23.7%, and 99.3%, respectively). Conclusion Our study showed that the mHEART score better detects short-term MACE in high-risk patients and ensures the safe disposition of low-risk patients than the HEART and TIMI scores.http://ceemjournal.org/upload/pdf/ceem-20-106.pdfchest painemergency service, hospitaladverse effectsprognosis |
| spellingShingle | Min Jae Kim Sang Ook Ha Young Sun Park Jeong Hyeon Yi Won Seok Yang Jin Hyuck Kim Validation and modification of HEART score components for patients with chest pain in the emergency department Clinical and Experimental Emergency Medicine chest pain emergency service, hospital adverse effects prognosis |
| title | Validation and modification of HEART score components for patients with chest pain in the emergency department |
| title_full | Validation and modification of HEART score components for patients with chest pain in the emergency department |
| title_fullStr | Validation and modification of HEART score components for patients with chest pain in the emergency department |
| title_full_unstemmed | Validation and modification of HEART score components for patients with chest pain in the emergency department |
| title_short | Validation and modification of HEART score components for patients with chest pain in the emergency department |
| title_sort | validation and modification of heart score components for patients with chest pain in the emergency department |
| topic | chest pain emergency service, hospital adverse effects prognosis |
| url | http://ceemjournal.org/upload/pdf/ceem-20-106.pdf |
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