Volume 73, March 2024, 101417Author links open overlay panel, , , , , , , AbstractIntroduction

Various scoring systems have been developed to safely rule out the diagnosis of acute coronary syndrome. Furthermore, the efficacy of these scoring systems in predicting the risk of major adverse cardiac events (MACE) is debated. Our aim was to compare parameters such as Integrated Pulmonary Index (IPI) and End Tidal Carbon Dioxide (etCO2) measured in the emergency department with the HEART score in terms of its success in predicting the risk of major adverse cardiac events.

Method

Patients with atypical chest pain were registered for the study by the emergency room physician. The patients were investigated regarding gender, age, background characteristics, prognostic accuracy of etCO2, IPI, MACE, and HEART scores.

Results

As a result of the analysis, higher HEART Score and lower etCO2 values were determined in the MACE group compared to the group without MACE. ROC analysis was performed to determine the power of IPI, HEART Score, and etCO2 to predict MACE. The findings revealed that IPI significantly predicted MACE with an AUC value of 0.737.

Conclusion

In our study, although the highest sensitivity values in determining the risk of 30-day MACE belonged to the HEART score, etCO2 and IPI might be other parameters that could be used to determine the risk of 30-day MACE.

Section snippetsIntroductıon

Chest pain accounts for the majority of reasons foremergency department admissions. Differential diagnoses in the patient group presenting to the emergency department with chest pain include a broad spectrum ranging from the simplest conditions that could be treated with a nonsteroidal anti-inflammatory drug to Acute Coronary Syndrome (ACS), where the patient can die within hours. It is vital for the safety of both the patient and the emergency doctor to make this differentiation quickly and

Patient selection

This prospective study was conducted between July 01, 2022, and December 01, 2022, in the Emergency Department of Erzurum City Hospital, a university hospital with approximately 1000 patients admitted daily. The study was performed by emergency medicine specialists, senior emergency medicine residents, and emergency room nurses. The local ethics committee approved the study, which was performed following the VMA Declaration of Helsinki, 1964, and later revisions. Detailed informed consent was

Results

A total of 131 patients who applied to the emergency department with chest pain complaints were identified for the study. Two of the 131 patients who did not accept coronary angiography (CAG) to be performed and 11 patients whose at least one of the baseline parameters was missing were excluded. The remaining 118 patients were included in the study. Of the 118 patients included in the study, 63 (53 %) were male, and 55 (47 %) were female. The participants’ parameters, such as age, vital signs,

Discussion

The findings of our study investigating the utility of IPI and etCO2 measurements in the emergency department in determining the risk of MACE in patients presenting with atypical chest pain were as follows: (1) As a result of the analysis, higher HEART Score and lower etCO2 values were determined in the MACE group compared to the group without MACE; (2) ROC analysis was performed to determine the power of IPI, HEART Score, and etCO2 to predict MACE. The findings revealed that IPI significantly

Limitations

Our study is the first to investigate the applicability of IPI score and etCO2 in predicting MACE in Atypical Chest patients. However, our study has some limitations. First, our study was a single-center study with a relatively small sample size. Second, the sensitivity and specificity of the HEART score, a cardiac risk score, in predicting MACE in our study were lower than in some studies in the literature. This result may be because, in our study, unlike the studies in the literature, MACE

Conclusion

In conclusion, every parameter that would be beneficial for the safe discharge of patients who apply to the emergency department with atypical chest pain is vital. In our study, although the highest sensitivity values in determining the risk of 30-day MACE belonged to the HEART score, we consider that etCO2 and IPI may be other parameters that can be used to determine the risk of 30-day MACE.

Ethical statement

The local ethics committee approved the study (The name of the chairperson of the ethics committee is Prof. Dr. Hasan KAHVECİ; the protocol number that was attributed by the ethics committee is 2022/07-83 and the date of approval by the ethics committee is 06.06.2022)

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

CRediT authorship contribution statement

Senol Arslan: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Supervision, Visualization, Writing – original draft, Writing – review & editing. Sibel Guçlu Utlu: Conceptualization, Formal analysis, Methodology, Resources, Supervision, Visualization, Writing – review & editing. Rıza Gucal: Conceptualization, Data curation, Methodology, Resources, Software, Supervision, Writing – original draft, Writing – review & editing. Furkan Akpinar: Conceptualization, Data

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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