مقايسه بين نمره دهي GRACE و TIMI در پيش بيني حوادث مهم قلبي عروقي در بيماران مراجعه كننده با درد قفسه سينه به بخش اورژانس بيمارستان طالقاني اروميه: گزارش كوتاه

Comparison between GRACE and TIMI scores in predicting significant cardiovascular events in patients with chest pain: brief report

درد سينه شايعترين علت مراجعه بيماران به اورژانس بيمارستان هاست كه اين مطالعه با هدف مقايسه بين نمره دهي GRACE و TIMI در پيش بيني حوادث مهم قلبي عروقي در بيماران مراجعه كننده با درد قفسه سينه به بخش اورژانس بيمارستان طالقاني اروميه انجام شد. روش بررسي اين مطالعه بصورت توصيفي- تحليلي بر روي 862 بيمار قلبي مراجعه كننده به اورژانس بيمارستان طالقاني اروميه در بازه زماني اول فروردين 1397 تا شهريور 1397 به روش سرشماري انجام شد كه براي گرد آوري اطلاعات از چك ليست استفاده شد، پس از جمع بندي امتيازات، تعيين سطح خطر انجام و پس از آن 30 روز پيگيري افراد انجام گرفت. يافته ها: نتايج نشان داد كه طي بررسي با سيستم GRACE و TIMI به ترتيب 52 نفر و هشت نفر پرخطر ارزيابي شدند. در ارزيابي MACE ميزان ويژگي سيستم (30GRACE (cutoff point= 89/27 مقابل 52/24 ويژگي سيستم TIMI (7/3cutoff point=) بود و حساسيت GRACE93 (10(cutoff point= در مقابل 85/71 (8/3TIMI (cutoff point= بود. نتيجه گيري: نتايج نشان داد كه حساسيت و ويژگي GRACE نسبت به TIMI بيشتر است. كليدواژگان: آنژين پكتورال، حوادث قلبي-عروقي، اورژانسي

Chest pain is the most common reason for patients to be referred to the emergency department of hospitals. This study was performed to compare the GRACE and TIMI scores in predicting important cardiovascular events in patients. Methods This descriptive-analytical study was performed on 862 cardiac patients who were referred to the emergency department of Taleghani Hospital in Urmia in the period of April 1, 2016 to the end of September 2016 by census method. A checklist containing demographic information, medical history and risk factors was used to collect data. After scoring patients, we examined and followed up both groups over the next 30 days and recorded any cardiovascular events such as sudden death, AMI or immediate revascularization. The data were tested using SPSS16 and descriptive statistics tests. T-test and ROC curve were analyzed. Results The results showed that in general, out of 862 patients who were studied (50.3%), 433 were female and (49.7%) 429 were male. Most of the patients were under 65 years old 627 (72.7%) and the age range was (17-91). The highest initial diagnosis of nonSTEMI patients was UA with 811 (94.9%) cases. On the other hand, the highest risk factors of patients were HTN 449(52%), CAD 314 (36.425) and DM 22 (25.55). The highest blood pressure was between (100-120) with 328 cases and serum creatinine between (0.6 to 1.3) with 770 cases. MACE after 30 days in GRACE system 17 people (32.69%) were in high risk group and in TIMI 3 people (37.5%) were in high risk group. In MACE evaluation, the specificity of GRACE system (cutoff point=30) was 89.27 vs. 52.24, the specificity of TIMI system (cutoff point=7.3) and the sensitivity of GRACE 93 (cutoff point=10) versus TIMI 85.71 (cutoff point=8.3) is. Conclusion The results showed that GRACE was more sensitive and characteristic than TIMI.