the challenge of triaging chest pain patients the bernese university hospital experience筛选胸痛患者的挑战伯恩大学医院的经验.pdfVIP

Hindawi Publishing Corporation Emergency Medicine International Volume 2012, Article ID 975614, 7 pages doi:10.1155/2012/975614 Clinical Study The Challenge of Triaging Chest Pain Patients: The Bernese University Hospital Experience 1 1 ¨ ¨ 1 2 1 Martin Rohacek, Amina Bertolotti, Nadine Grutzmuller, Urs Simmen, Hans Marty, Heinz Zimmermann,1 Aristomenis Exadaktylos,1 and Arampatzis Spyridon1 1 Department of Emergency Medicine, University Hospital Bern, Freiburgstrasse, 3010 Bern, Switzerland 2 Statistical Consulting, Malzgase 9, 3042 Basel, Switzerland Correspondence should be addressed to Arampatzis Spyridon, spiros.arampatzis@ Received 17 May 2011; Revised 15 July 2011; Accepted 29 July 2011 Academic Editor: Adrian Boyle Copyright © 2012 Martin Rohacek et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Accurate diagnosis of the causes of chest pain and dyspnea remain challenging. In this preliminary observational study with a 5-year follow-up, we attempted to find a simplified approach to selecting patients with chest pain needing immediate care based on the initial evaluation in ED. During a 24-month period were randomly selected 301 patients and a conditional inference tree (CIT) was used as the basis of the prognostic rule. Common diagnoses were musculoskeletal chest pain (27%), ACS (19%) and panic attack (12%). Using variables of ACS symptoms we estimated the likelihood of ACS based on a CIT to be high at 91% (3