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Convergence of nurses-physicians calculated HEART pathway in patients with chest pain and its role in predicting major adverse cardiovascular events (MACE)
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Hanieh Aghakhani1   , Zahra Behpour2 , Zahra Amirsardari1 , Mohammad Esmaeil Zanganehfar1 , Melody Farrashi1 , Hooman Bakhshandeh1 , Parham Sadeghipour * 3, Hojjat Mortezaeian1 , Abolfath Alizadeh1 , Bahador Baharestani1 |
1- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
2- Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
3- Associate Professor, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran , psadeghipour@hotmail.com |
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Abstract: (328 Views) |
Abstract
Aim. This study aimed at examining the convergence of calculated HEART pathway by physician and nurse along its utility to predict the 3-month occurrence of major adverse cardiac even (MACE) in patients with chest pain admitted to emergency department (ED).
Background. The HEART pathway is a tool to predict MACE in patients with chest pain admitted to ED, to help risk stratification for early discharge and reduce unnecessary cardiac tests.
Method. In the present study, a diagnostic tool was evaluated. Ninety-seven ED patients with acute chest pain, hospitalized in Rajaie Cardiovascular Medical and Research Center, were recruited prospectively. Risk stratification was performed by an ED nurse, a cardiology resident, and a cardiology attending physician. The correlation and the 3-month MACE outcomes were analyzed.
Findings. Pairwise agreements were excellent between the raters. The Intraclass Correlation Coefficient (ICC) among raters were 0.84 (95% CI: 0.73–0.97) and thus, overall agreement was excellent. The HEART pathway score showed a high predictive power (AUC: 0.85 for 3-month MACE). For a cut-off score of 4, sensitivity, specificity, and negative predictive values were 87.5, 58.9, and 95.8 percent, respectively.
Conclusion. The HEART pathway score predicted effectively 3-month MACE in patients with acute non-traumatic chest pain. The high agreement among the three different raters suggests that nurses might use efficiently the score. |
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| Keywords: Acute chest pain, Emergency Department, HEART pathway, Physician, Nurse |
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Full-Text [PDF 1003 kb]
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: Research |
Subject:
Cardiovascular
Received: 2023/12/09 | Accepted: 2023/03/30 | Published: 2024/01/09 | ePublished: 2024/01/09
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