Diagnostic Performance of "Emergency Department Assessment of Chest Pain Score"

Acute Chest Pain Clinical Trial

Official title:

Diagnostic Performance of "Emergency Department Assessment of Chest Pain Score" in Patients With Acute Chest Pain.

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05175144
• Other study ID #: Chest Pain Score
• Status: Not yet recruiting
• Start date: December 1, 2022
• Est. completion date: June 1, 2025

Study information

• Verified date: July 2022
• Source: Assiut University
• Contact: Arwa S. Abdelaziz, resident
• Phone: +201156748809
• Email: arwasalah.ed[@]gmail.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This study aims to evaluate whether EDACS performed during triage to assess patients with chest pain could improve the predictive validity of triage for an acute cardiovascular event.

Description:

Chest pain is common reasons for presentation to the emergency department (ED).Up to 6.3% of emergency department (ED) visits are related to chest pain. Causes of chest pain range from musculoskeletal chest pain to potentially life-threatening emergencies as acute coronary syndrome(ACS), aortic dissection or pulmonary embolism. Therefore, accurate and fast risk stratification is paramount in the acute management, mainly to identify those patients with immediate risk of complications, as those with an ACS. Those patients are challenging to discriminate, as there is a variety of clinical manifestations.

Chest pain is considered to be an acute chest pain, described as pain, pressure, tightness, or burning as outlined in the guidelines Chest pain equivalent symptoms may include dyspnea, left arm, and epigastric pain.

Triage helps recognize the urgency among patients. An accurate triage decision helps patients receive the emergency service in the most appropriate time. Various triage systems have been developed and verified to assist healthcare providers to make accurate triage decisions. Despite good levels of specificity, the available triage systems appear to have suboptimal sensitivities that cannot adequately prioritize patients with acute cardiovascular diseases. The Emergency Department Assessment of Chest Pain Score (EDACS), through a standardized assessment of the patient's history and presenting symptoms only, provides good levels of sensitivity in stratifying time dependent acute cardiovascular diseases. The good discriminatory ability of EDACS, combined with its easy clinical applicability, could be used to overcome some of the limitations of triage systems in assessing chest pain.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 146
• Est. completion date: June 1, 2025
• Est. primary completion date: January 1, 2024
• Gender: All
• Age group: 18 Years to 90 Years

Eligibility

Inclusion Criteria:

• Patients >18 years old who admitted to ED complaining of chest pain.

• Chest pain is considered to be an acute chest pain, described as pain, pressure, tightness, or burning as outlined in the guidelines.

• Chest pain equivalent symptoms may include dyspnea, epigastric pain, and pain in the left arm.

Exclusion Criteria:

• Patients unable to complete the EDACS

• Posttraumatic chest pain

• Patients who did not give consent to participate

Related Conditions & MeSH terms

• Acute Chest Pain
• Chest Pain
• Emergencies

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Assiut University

References & Publications (7)

Bayón Fernández J, Alegría Ezquerra E, Bosch Genover X, Cabadés O'Callaghan A, Iglesias Gárriz I, Jiménez Nácher JJ, Malpartida De Torres F, Sanz Romero G; Grupo de Trabajo ad hoc de la Sección de Cardiopatía Isquémica y Unidades Coronarias de la Sociedad Española de Cardiología. [Chest pain units. Organization and protocol for the diagnosis of acute coronary syndromes]. Rev Esp Cardiol. 2002 Feb;55(2):143-54. Review. Spanish. — View Citation

Flaws D, Than M, Scheuermeyer FX, Christenson J, Boychuk B, Greenslade JH, Aldous S, Hammett CJ, Parsonage WA, Deely JM, Pickering JW, Cullen L. External validation of the emergency department assessment of chest pain score accelerated diagnostic pathway (EDACS-ADP). Emerg Med J. 2016 Sep;33(9):618-25. doi: 10.1136/emermed-2015-205028. Epub 2016 Jul 12. — View Citation

Hinson JS, Martinez DA, Cabral S, George K, Whalen M, Hansoti B, Levin S. Triage Performance in Emergency Medicine: A Systematic Review. Ann Emerg Med. 2019 Jul;74(1):140-152. doi: 10.1016/j.annemergmed.2018.09.022. Epub 2018 Nov 22. — View Citation

Niska R, Bhuiya F, Xu J. National Hospital Ambulatory Medical Care Survey: 2007 emergency department summary. Natl Health Stat Report. 2010 Aug 6;(26):1-31. — View Citation

Than M, Flaws D, Sanders S, Doust J, Glasziou P, Kline J, Aldous S, Troughton R, Reid C, Parsonage WA, Frampton C, Greenslade JH, Deely JM, Hess E, Sadiq AB, Singleton R, Shopland R, Vercoe L, Woolhouse-Williams M, Ardagh M, Bossuyt P, Bannister L, Cullen L. Development and validation of the Emergency Department Assessment of Chest pain Score and 2 h accelerated diagnostic protocol. Emerg Med Australas. 2014 Feb;26(1):34-44. doi: 10.1111/1742-6723.12164. Epub 2014 Jan 15. — View Citation

Than MP, Pickering JW, Aldous SJ, Cullen L, Frampton CM, Peacock WF, Jaffe AS, Goodacre SW, Richards AM, Ardagh MW, Deely JM, Florkowski CM, George P, Hamilton GJ, Jardine DL, Troughton RW, van Wyk P, Young JM, Bannister L, Lord SJ. Effectiveness of EDACS Versus ADAPT Accelerated Diagnostic Pathways for Chest Pain: A Pragmatic Randomized Controlled Trial Embedded Within Practice. Ann Emerg Med. 2016 Jul;68(1):93-102.e1. doi: 10.1016/j.annemergmed.2016.01.001. — View Citation

Zaboli A, Ausserhofer D, Sibilio S, Toccolini E, Bonora A, Giudiceandrea A, Rella E, Paulmichl R, Pfeifer N, Turcato G. Effect of the Emergency Department Assessment of Chest Pain Score on the Triage Performance in Patients With Chest Pain. Am J Cardiol. 2021 Dec 15;161:12-18. doi: 10.1016/j.amjcard.2021.08.058. Epub 2021 Oct 9. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Diagnostic performance of EDACS for detection of acute cardiovascular events in emergency department.		baseline
Secondary	Baseline characteristics for patients with acute cardiovascular events.		baseline