Validation of the Emergency Department Assessment of Chest Pain Score and its accelerated diagnostic protocol in a Turkish cohort

Authors : Neslihan Ergün Süzer, Ali Cankut Tatliparmak

Pages : 188-193

View : 26 | Download : 8

Publication Date : 2025-06-18

Article Type : Research Paper

Abstract :Aims: The Emergency Department Assessment of Chest Pain Score (EDACS) and its accelerated diagnostic protocol (EDACS ADP) are widely used for risk stratification of chest pain patients. This study evaluated their diagnostic performance in a Turkish cohort. Methods: This retrospective cross-sectional study analyzed patients presenting with chest pain to a Turkish Emergency Department (ED). Major adverse cardiac event (MACE) occurrence was determined through clinical follow-up and medical record review. The diagnostic accuracy of EDACS and EDACS-ADP in predicting MACE was evaluated. Results: A total of 744 patients were included, with 94 (12.6%) in the MACE group and 650 (87.4%) in the no-MACE group. The median EDACS score was higher in the MACE group (20 [IQR 14-24] vs. 15 [IQR 9.75-20], p<0.001). EDACS sensitivity was 71.3% (95% CI 61.0-80.1), while EDACS-ADP achieved 100% (95% CI 96.2-100.0). Specificity was similar (EDACS: 52.3% [95% CI 48.4-56.2]; EDACS-ADP: 52.2% [95% CI 48.2-56.1]). EDACS-ADP had a higher positive likelihood ratio (PLR) (2.09 [95% CI 1.93-2.26] vs. 1.49 [95% CI 1.28-1.73]) and a lower negative likelihood ratio (NLR) (0 vs. 0.55 [95% CI 0.4-0.76]). Positive predictive value (PPV) was higher for EDACS-ADP (23.2% [95% CI 21.8-24.7]) than for EDACS (17.8% [95% CI 15.7-20.1]), while negative predictive value (NPV) was 100% for EDACS-ADP and 92.6% (95% CI 90.1-94.6) for EDACS. Conclusion: EDACS effectively identified high-risk patients, while EDACS-ADP achieved 100% sensitivity and NPV, making it a reliable tool for safely discharging low-risk patients in a Turkish ED cohort.
Keywords : göğüs ağrısı, skorlar, majör kardiyak advers olaylar, tanısal performans, acil servis

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