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

NCT ID: NCT05175144

Last Updated: 2022-08-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

146 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-12-01

Study Completion Date

2025-06-01

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Acute Chest Pain

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Arwa Salah Abdelaziz Ali

resident

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Arwa S. Abdelaziz, resident

Role: CONTACT

+201156748809

Alaa M. Ahmed, professor

Role: CONTACT

00201223591937

References

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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.

Reference Type BACKGROUND
PMID: 27406833 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 24428678 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 26947800 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 20726217 (View on PubMed)

Bayon Fernandez J, Alegria Ezquerra E, Bosch Genover X, Cabades O'Callaghan A, Iglesias Garriz I, Jimenez Nacher JJ, Malpartida De Torres F, Sanz Romero G; Grupo de Trabajo ad hoc de la Seccion de Cardiopatia Isquemica y Unidades Coronarias de la Sociedad Espanola de Cardiologia. [Chest pain units. Organization and protocol for the diagnosis of acute coronary syndromes]. Rev Esp Cardiol. 2002 Feb;55(2):143-54. doi: 10.1016/s0300-8932(02)76574-3. Spanish.

Reference Type BACKGROUND
PMID: 11852005 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 30470513 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 34635312 (View on PubMed)

Other Identifiers

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Chest Pain Score

Identifier Type: -

Identifier Source: org_study_id

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