open access

Vol 6, No 1 (2021)
Research paper
Published online: 2021-03-16
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Clinical utility of EDACS-ADP in patients admitted with chest pain to an emergency department

Ilker Akbas, Zeynep Cakir, Abdullah Osman Kocak, Alpaslan Ünlü, Nazim Onur Can, Mert Vural, Muhammed Zübeyr Köse
DOI: 10.5603/DEMJ.a2021.0008
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Disaster Emerg Med J 2021;6(1):33-40.

open access

Vol 6, No 1 (2021)
ORIGINAL ARTICLES
Published online: 2021-03-16

Abstract

BACKGROUND: Acute coronary syndrome (ACS) is a common cause of mortality and morbidity. An ACS diagnosis can be made with electrocardiogram (ECG) and cardiac markers. However, despite medical advances, 2–5% of ACS patients are undiagnosed and discharged from emergency departments (EDs) because clinicians often find it difficult not only to diagnose and treat high-risk patients but also to define nonemergency diseases or safely discharge healthy patients. Risk stratification can be prevented, and inappropriate diagnosis and treatment protocols can be identified. The ED Assessment of Chest Pain Score-Accelerated Diagnostic Protocol (EDACS-ADP) scoring system, developed to identify patients with chest pain but at low risk for a major adverse cardiac event (MACE), is the first score based on clinical data from emergency medicine.   OBJECTIVES: This study investigates the usability of EDACS-ADP in Turkey.   MATERIALS AND METHODS: This is a prospective observational study of 392 patients. The primary outcome was a major adverse cardiovascular event (MACE) within thirty days.   RESULTS: A total of 116 MACEs occurred in 65 (16,6%) patients during a one-month follow-up. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+ LR), and negative likelihood ratio (–LR) values of the EDACS-ADP score for the evaluation of 30-day MACE rate in patients who admitted with chest pain for two months were as follows: 96.9%, 64.5%, 35.2%, 99.1%, + LR: 2.73, and –LR: 0.05.   CONCLUSION: Most of these patients were classified by the EDACS-ADP as low risk and suitable for discharge. The 30-day MACE rate of development was significantly low (0.9%) and acceptable in patients grouped as low risk.

Abstract

BACKGROUND: Acute coronary syndrome (ACS) is a common cause of mortality and morbidity. An ACS diagnosis can be made with electrocardiogram (ECG) and cardiac markers. However, despite medical advances, 2–5% of ACS patients are undiagnosed and discharged from emergency departments (EDs) because clinicians often find it difficult not only to diagnose and treat high-risk patients but also to define nonemergency diseases or safely discharge healthy patients. Risk stratification can be prevented, and inappropriate diagnosis and treatment protocols can be identified. The ED Assessment of Chest Pain Score-Accelerated Diagnostic Protocol (EDACS-ADP) scoring system, developed to identify patients with chest pain but at low risk for a major adverse cardiac event (MACE), is the first score based on clinical data from emergency medicine.   OBJECTIVES: This study investigates the usability of EDACS-ADP in Turkey.   MATERIALS AND METHODS: This is a prospective observational study of 392 patients. The primary outcome was a major adverse cardiovascular event (MACE) within thirty days.   RESULTS: A total of 116 MACEs occurred in 65 (16,6%) patients during a one-month follow-up. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+ LR), and negative likelihood ratio (–LR) values of the EDACS-ADP score for the evaluation of 30-day MACE rate in patients who admitted with chest pain for two months were as follows: 96.9%, 64.5%, 35.2%, 99.1%, + LR: 2.73, and –LR: 0.05.   CONCLUSION: Most of these patients were classified by the EDACS-ADP as low risk and suitable for discharge. The 30-day MACE rate of development was significantly low (0.9%) and acceptable in patients grouped as low risk.

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Keywords

chest pain, chest pain score, EDACS, ADP

About this article
Title

Clinical utility of EDACS-ADP in patients admitted with chest pain to an emergency department

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 6, No 1 (2021)

Article type

Research paper

Pages

33-40

Published online

2021-03-16

DOI

10.5603/DEMJ.a2021.0008

Bibliographic record

Disaster Emerg Med J 2021;6(1):33-40.

Keywords

chest pain
chest pain score
EDACS
ADP

Authors

Ilker Akbas
Zeynep Cakir
Abdullah Osman Kocak
Alpaslan Ünlü
Nazim Onur Can
Mert Vural
Muhammed Zübeyr Köse

References (16)
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