Tehran University Medical Journal

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Background: 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.

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Background: Acute compartment syndrome is considered a debilitating complication of limb trauma. Early detection of this compartment syndrome helps us in the early initiation of treatment which will result in preventing its subsequent complications reported in these cases.
Methods: This research was an analytical cross-sectional study. Patients with direct trauma to extremities, who were referred to the emergency department of Valiasr and Amir Al-Momenin hospitals were studied from October 2018 to April 2019 in Arak, Iran. Patients were selected if they met all of the inclusion criteria and none of the exclusion criteria. Vital signs were measured and recorded for each patient. Also, the results of physical examination, intra-compartmental pressure measurement by a wick catheter and the level of the creatine phosphokinase were recorded. All data analyses were performed with the use of SPSS v21 software.

Results: A total number of 70 subjects were included in this study, comprising 65 males (93.1%) and 5 females (6.9%). The results showed that there is a significant relationship between intra-compartment pressure and the level of creatine phosphokinase enzyme. The higher the intracompartmental pressure, the higher the creatine phosphokinase level. Statistically significant associations were observed between intracompartmental pressure and pallor, edema, lack of limb pulse, and diastolic blood pressure. No significant relationship was found between intracompartmental pressure and limb pain, numbness, inability to move the injured limbs, and systolic blood pressure. In addition, our findings indicated that creatine phosphokinase is significantly associated with edema and lack of limb pulse. No significant relationship was found between creatine phosphokinase with pain, pallor, numbness, inability to move limbs, and systolic and diastolic blood pressure. Conclusion: The study findings suggest that measurement of intracompartmental pressure could be considered as an effective alternative approach to creatine phosphokinase levels to diagnose compartment syndrome. So, this will prevent irreparable damage to the extremities and is of great importance.