Observational studyBMC cardiovascular disorders2015
Chest pain in the emergency department: risk stratification with Manchester triage system and HEART score.
Observational study in BMC cardiovascular disorders, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03115190 (A Prospective Cohort Study to Improve the Accuracy of Referrals of Patients With Chest Pain to the Emergency Department), which is not on this map. Cited by 28 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Prospective Cohort Study to Improve the Accuracy of Referrals of Patients With Chest Pain to the Emergency Department: to Decrease the Delay in Acute Coronary Syndrome Patients and Rule Out Non-cardiac Chest Pain Patients (URGENT)
Who cites it
28 citing papers in PubMed, 79 citations in OpenAlex.
- Trial
- Manchester Triage System: Effectiveness, Limitations, and Global Implementation-A Structured Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Association of Early Noninvasive Cardiac Stress Testing With Acute Myocardial Infarction and Mortality.Annals of emergency medicine · 2025Article
- Sex differences in chest pain presentation, triage assessment, and outcomes in urgent primary care: findings from the TRACE cohort study.Primary health care research & development · 2025Article
- Performance of computerized self-reported medical history taking and HEAR score for safe early rule-out of cardiac events in acute chest pain patients: the CLEOS-CPDS prospective cohort study.European heart journal. Digital health · 2025Article
- HEART Score: Prospective Evaluation of Its Accuracy and Applicability.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- [Comparison of Heart, Grace Scores and clinical parameters as predictors of cardiovascular events in patients with chest pain in the Emergency Department].Revista espanola de salud publica · 2023Observational
- Evaluation of telephone triage among chest pain patients in out-of-hours primary care in the Netherlands (TRACE).Family practice · 2023Observational
- Observational
- Article
- Predictors of critical illness among young males with chest pain, abdominal pain, or headaches in the Republic of Korea Army.Encephalitis (Seoul, Korea) · 2022Article
- Effect of the Emergency Department Assessment of Chest Pain Score on the Triage Performance in Patients With Chest Pain.The American journal of cardiology · 2021Observational
- Comparison of self-reported EDACS versus physician-reported EDACS for the triage of chest pain patients in the emergency department.Journal of the American College of Emergency Physicians open · 2021Article
- HEART Score in Predicting One-Month Major Adverse Cardiac Events in Patients with Acute Chest Pain; a Diagnostic Accuracy Study.Archives of academic emergency medicine · 2021Article
- Accuracy of telephone triage in patients suspected of transient ischaemic attack or stroke: a cross-sectional study.BMC family practice · 2020Article
- Article
- Real-time AI prediction for major adverse cardiac events in emergency department patients with chest pain.Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Article
- Exploring the complex interactions of baseline patient factors to improve nursing triage of acute coronary syndrome.Research in nursing & health · 2020Article
- Accuracy of telephone triage in primary care patients with chest discomfort: a cross-sectional study.Open heart · 2020Article
- Evaluation of the Manchester triage system for patients with acute coronary syndrome.Wiener klinische Wochenschrift · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFast and accurate chest pain risk stratification in the emergency department (ED) is critical. The HEART score predicts the short-term incidence of major adverse cardiac events (MACE) in this population, dividing it in three risk categories. We aimed to describe the population with chest pain, to characterize the subgroup of patients with acute coronary syndrome (ACS) and to assess the prognostic value of Manchester triage system and of HEART score.
methodsRetrospective observational study including patients admitted to the ED of a tertiary hospital with chest pain as the presenting symptom. The primary outcome was a composite of all-cause mortality, myocardial infarction or unscheduled revascularization at 6 weeks.
resultsWe enrolled 233 patients (age 58 ± 19; 55.4 % males). The most common final diagnosis was non-specific chest pain (n = 86, 36.9 %), followed by ACS (n = 22, 9.4 %). Male gender, smoking and chronic kidney disease were associated with higher risk of ACS. According to Manchester triage system, chest pain patients stratified with red or orange priority had a higher incidence of ACS (16.5 % vs. 3.8 %, p = 0.006). The application of HEART score showed that most patients were in low risk category (56.3 %). The six-week incidence of MACE in each category was 2 %, 15.6 % and 76.9 % (p < 0.001). HEART score accurately predicted the short-term incidence of MACE in chest pain patients (c-statistic 0.880; 95 % CI, 0.807-0.950, p < 0.001).
conclusionsChest pain patients have very different levels of severity and the discriminatory power of Manchester triage system should be used in the assessment of this population. The HEART score seems to be an effective tool for risk stratification in the ED.
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