Validation of a clinical prediction score for ruling out coronary heart disease in primary care patients with chest pain.

Détails

ID Serval
serval:BIB_A4178EEC5E02
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Titre
Validation of a clinical prediction score for ruling out coronary heart disease in primary care patients with chest pain.
Titre de la conférence
15th Wonca Europe Conference, Basel (Switzerland), 16-19 September 2009
Auteur(s)
Gencer Baris, Vaucher Paul, Boesner Stefan, Herzig Lilli, Verdon François, Ruffieux Christiane, Burnand Bernard, Bischoff Thomas, Donner-Banzhoff Norbert, Favrat Bernard
ISBN
1424-7860
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
139
Série
Swiss Medical Weekly
Pages
39S
Langue
anglais
Résumé
Background: A patient's chest pain raises concern for the possibility of coronary heart disease (CHD). An easy to use clinical prediction rule has been derived from the TOPIC study in Lausanne. Our objective is to validate this clinical score for ruling out CHD in primary care patients with chest pain.
Methods: This secondary analysis used data collected from a oneyear follow-up cohort study attending 76 GPs in Germany. Patients attending their GP with chest pain were questioned on their age, gender, duration of chest pain (1-60 min), sternal pain location, pain increases with exertion, absence of tenderness point at palpation, cardiovascular risks factors, and personal history of cardiovascular disease. Area under the curve (ROC), sensitivity and specificity of the Lausanne CHD score were calculated for patients with full data.
Results: 1190 patients were included. Full data was available for 509 patients (42.8%). Missing data was not related to having CHD (p = 0.397) or having a cardiovascular risk factor (p = 0.275). 76 (14.9%) were diagnosed with a CHD. Prevalence of CHD were respectively of 68/344 (19.8%), 2/62 (3.2%), 6/103 (5.8%) in the high, intermediate and low risk category. ROC was of 72.9 (CI95% 66.8; 78.9). Ruling out patients with low risk has a sensitivity of 92.1% (CI95% 83.0; 96.7) and a specificity of 22.4% (CI95% 18.6%; 26.7%).
Conclusion: The Lausanne CHD score shows reasonably good sensitivity and can be used to rule out coronary events in patients with chest pain. Patients at risk of CHD for other rarer reasons should nevertheless also be investigated.
Mots-clé
Chest Pain, Coronary Disease/diagnosis, Primary Health Care, Predictive Value of Tests
Création de la notice
18/06/2010 11:15
Dernière modification de la notice
03/03/2018 20:13
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