vancouver chest pain

OBJECTIVES: To externally evaluate the accuracy of the new Vancouver Chest Pain Rule and to assess the diagnostic accuracy using either sensitive or highly sensitive troponin assays. METHODS: Prospectively collected data from 2 emergency departments (EDs) in Australia and New Zealand were analysed. Based on the new Vancouver Chest Pain Rule, low-risk patients were identified using electrocardiogram results, cardiac history, nitrate use, age, pain characteristics and troponin results at 2 hours after presentation...

OBJECTIVES: The objective of this study is to evaluate the accuracy of the Vancouver Chest Pain Rule using troponin as the only biomarker in an emergency department (ED) setting. METHODS: This is an analysis of prospectively collected data from 2 EDs in Australia and New Zealand. Trained research nurses collected clinical data using a customised case report form. Based on a modified Vancouver Chest Pain Rule using troponin as the only biomarker, low-risk patients were identified using clinical history, age, pain characteristics, electrocardiography, and troponin results at 0 and 2 hours after presentation...

OBJECTIVES: The objective was to validate the Vancouver Chest Pain Rule in an emergency department (ED) setting to identify very-low-risk patients with acute chest pain. METHODS: A prospective cohort study was conducted on consecutive patients 25 years of age and older presenting to the ED with a chief complaint of acute chest pain during January 2009 to July 2009. According to the Vancouver Chest Pain Rule, cardiac history, chest pain characteristics, physical and electrocardiogram (ECG) findings, and cardiac biomarker measurement (creatine kinase-myocardial band isoenzyme [CK-MB]) were used to identify patients with very low risk for developing acute coronary syndrome (ACS) in 30 days...

OBJECTIVES: The aim of this study was to estimate the potential cost-effectiveness and expected value of perfect information of a recently derived clinical prediction rule for patients presenting to emergency departments with chest discomfort. METHODS: A decision analytic model was constructed to compare the Early Disposition Prediction Rule (EDPR) with the current standard of care. Results were used to calculate the potential cost-effectiveness of the EDPR, as well as the Value of Information in conducting further research...

STUDY OBJECTIVE: To find out if gender and ethnicity are associated with acute myocardial infarction (AMI) symptom recognition and the recommendation of enlisting emergency medical services. DESIGN: In an experiment, a random sample of the public was provided a scenario of a person experiencing symptoms of AMI; the gender of the character (male, female, or indeterminate) was manipulated. SETTING: Vancouver, Canada PARTICIPANTS: 976 people from a population based random sample of 3419 people, 40 years of age and older, participated in a telephone survey given in English, Cantonese, Mandarin, and Punjabi...

STUDY OBJECTIVE: Current risk stratification tools do not identify very-low-risk patients who can be safely discharged without prolonged emergency department (ED) observation, expensive rule-out protocols, or provocative testing. We seek to develop a clinical prediction rule applicable within 2 hours of ED arrival that would miss fewer than 2% of acute coronary syndrome patients and allow discharge within 2 to 3 hours for at least 30% of patients without acute coronary syndrome. METHODS: This prospective, cohort study enrolled consenting eligible subjects at least 25 years old at a single site...

BACKGROUND: Currently, there is no standardized, comprehensive method to assess surgical scars after breast cancer surgery. This article evaluates the application of the Vancouver Scar Scale, in conjunction with patients' scar self-rating and scar-related pain, in a cohort of breast cancer patients. METHODS: Data were prospectively collected in 59 women with breast cancer. Scar assessment comprised: 1. objective rating by pairs of independent observers using the Vancouver Scar Scale; 2...

The purpose of this study was to evaluate the door-to-needle time for fibrinolytic administration for acute myocardial infarction (AMI) at Vancouver General Hospital (VGH) and identify factors associated with time prolongation. A retrospective chart review of all patients fibrinolysed for AMI in the ED at VGH was performed from January 1, 1998, to December 31, 1999, to determine door-to-needle time. A mixed-effects linear regression model was fit to the fibrinolytic data with the door-to-needle time to identify factors associated with prolonged times...

A telephone survey of 349 randomly-selected women living in Greater Vancouver was conducted to assess their understanding of acute myocardial infarction (AMI). The results revealed that women have not yet personalized AMI risk information. Participants indicated a need for more information pertaining to symptom recognition for AMI; they were largely unaware that females may experience AMI differently than do males. Participants were less aware of the risks that diabetes, obesity and menopause pose for AMI. Approximately 36% of these women intended to delay treatment-seeking in the presence of suspicious AMI symptoms...

During the 1986 World's Exposition held in Vancouver, British Columbia, the types and frequencies of emergency medical problems were assessed. The average number of patients seeking care was 3.93 +/- 0.95 per 1,000 visitors (daily range, 1.94 to 6.8). Patient loads were linearly related to gate attendance, but the correlation was imperfect (P less than .001, r = .63). Only 4.4% of patients evaluated on site by nurses and paramedics were referred for additional testing and treatment: of these patients, 30% had suspected serious musculoskeletal injury, 16% had abdominal pain, and 25% had complaints of chest pain, dizziness, or loss of consciousness...

1. One hundred consecutive patients admitted with ischemic chest pain to the Emergency Department of Vancouver General Hospital were studied. The diagnosis was based on clinical assessment, EKG changes and the total CPK and LDH activities. However, unknown to the clinician. CPK and LDH isozyme determinations were also carried out and their possible impact on the diagnosis and management of the patients was evaluated retrospectively. In 37 patients with definitive myocardial infarction by all the above mentioned criteria the isozyme dterminations were of no further help...