Tehran University Medical Journal
مجله دانشکده پزشکی، دانشگاه علوم پزشکی تهران
Tehran Univ Med J
Medical Sciences
http://tumj.tums.ac.ir
1
admin
1683-1764
1735-7322
10.18869/acadpub.tumj
000
000
000
fa
jalali
1400
2
1
gregorian
2021
5
1
79
2
online
1
fulltext
other
مقایسه بین نمرهدهی GRACE و TIMI در پیشبینی حوادث مهم قلبی عروقی در بیماران مراجعهکننده با درد قفسه سینه به بخش اورژانس بیمارستان طالقانی ارومیه: گزارش کوتاه
Comparison between GRACE and TIMI scores in predicting significant cardiovascular events in patients with chest pain: brief report
گزارش كوتاه
Brief Report
<span style="font-family:yekanYW;"><strong><em><span style="font-size:10.0pt;">زمینه و هدف:</span></em></strong><span style="font-size:10.0pt;"> درد سینه شایعترین علت مراجعه بیماران به اورژانس بیمارستانهاست که این مطالعه با هدف مقایسه بین نمرهدهی </span><span dir="LTR"><span style="font-size:8.0pt;">GRACE</span></span><span style="font-size:10.0pt;"> و </span><span dir="LTR"><span style="font-size:8.0pt;">TIMI</span></span><span style="font-size:10.0pt;"> در پیشبینی حوادث مهم قلبی عروقی در بیماران مراجعهکننده با درد قفسه سینه به بخش اورژانس بیمارستان طالقانی ارومیه انجام شد.</span><br>
<strong><em><span style="font-size:10.0pt;">روش بررسی:</span></em></strong> <span style="font-size:10.0pt;">این مطالعه بصورت توصیفی- تحلیلی بر روی ۸۶۲ بیمار قلبی مراجعهکننده به اورژانس بیمارستان طالقانی ارومیه در بازه زمانی اول فروردین 1397 تا شهریور 1397 به روش سرشماری انجام شد که برای گردآوری اطلاعات از چکلیست استفاده شد، پس از جمعبندی امتیازات، تعیین سطح خطر انجام و پس از آن ۳۰ روز پیگیری افراد انجام گرفت.</span><br>
<strong><em><span style="font-size:10.0pt;">یافتهها:</span></em></strong> <span style="font-size:10.0pt;">نتایج نشان داد که طی بررسی با سیستم </span><span dir="LTR"><span style="font-size:8.0pt;">GRACE</span></span><span style="font-size:10.0pt;"> و </span><span dir="LTR"><span style="font-size:8.0pt;">TIMI</span></span><span style="font-size:10.0pt;"> بهترتیب ۵۲ نفر و هشت نفر پرخطر ارزیابی شدند. در ارزیابی </span><span dir="LTR"><span style="font-size:8.0pt;">MACE</span></span><span style="font-size:10.0pt;"> میزان ویژگی سیستم (30</span><span dir="LTR"><span style="font-size:8.0pt;">GRACE (cutoff point=</span></span><span style="font-size:10.0pt;"> 27/89 مقابل ۲۴/۵۲ ویژگی سیستم </span><span dir="LTR"><span style="font-size:8.0pt;">TIMI </span></span><span style="font-size:10.0pt;"> (3/7</span><span dir="LTR"><span style="font-size:8.0pt;">cutoff point=</span></span><span style="font-size:10.0pt;">) بود و حساسیت </span> <span dir="LTR"><span style="font-size:8.0pt;">GRACE</span></span><span style="font-size:10.0pt;">۹۳ (10</span><span dir="LTR"><span style="font-size:8.0pt;">(cutoff point=</span></span><span style="font-size:10.0pt;"> در مقابل ۷۱/۸۵ (3/8</span><span dir="LTR"><span style="font-size:8.0pt;">TIMI (cutoff point=</span></span><span style="font-size:10.0pt;"> بود.</span><br>
<strong><em><span style="font-size:10.0pt;">نتیجهگیری:</span></em></strong> <span style="font-size:10.0pt;">نتایج نشان داد که حساسیت و ویژگی </span><span dir="LTR"><span style="font-size:8.0pt;">GRACE</span></span><span style="font-size:10.0pt;"> نسبت به </span><span dir="LTR"><span style="font-size:8.0pt;">TIMI</span></span><span style="font-size:10.0pt;"> بیشتر است.</span><span dir="LTR"><span style="font-size:8.0pt;"></span></span></span>
<strong><em>Background:</em></strong> 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.<br>
<strong><em>Methods:</em></strong> 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.
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<td align="left"><strong><em>Results:</em></strong> 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.<br>
<strong><em>Conclusion:</em></strong> The results showed that GRACE was more sensitive and characteristic than TIMI.<span dir="RTL"></span></td>
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آنژین پکتورال, حوادث قلبی-عروقی, اورژانسی.
angina pectoris, cardiovascular system, emergencies.
150
155
http://tumj.tums.ac.ir/browse.php?a_code=A-10-3666-390&slc_lang=other&sid=1
Hamidreza
Mehryar
حمیدرضا
مهریار