Triage of patients with acute coronary syndrome at the emergency department: A retrospective study

Abstract

Background: Acute coronary syndrome represents a considerable challenge worldwide as one of the causes of death; its diagnosis is often very complex. It includes acute myocardial infarction with ST-segment elevation, acute myocardial infarction without ST-segment elevation, unstable angina pectoris, and sudden cardiac arrest. Methods: This retrospective cohort study included 678 patients who were admitted to the emergency department between 2015 and 2019 with acute coronary syndrome. Triage data were reviewed for vital signs, baseline characteristics, chief complaints, demographic variables, mode and time of arrival, triage, diagnosis, and treatment. Regression was used to identify key symptoms and patient characteristics at triage encounter to predict acute coronary syndrome. Results: A total of 678 triage records were identified. The average age of the sample was 67 years old, 58.6% male, and 31.8% came by themselves to the emergency department. The most common diagnosis was acute myocardial infarctions without ST elevation (38.2%). Chest pain and difficulty in breathing were the two most common symptoms. Most patients were not assigned to the appropriate triage category, i.e., were diagnosed as less urgent. Discussion and conclusion: This study presents the triage of patients with acute coronary syndrome at the emergency department to provide a comprehensive insight into their care. By identifying patient symptoms at the emergency department, nurse triage recognizes patients with acute coronary syndrome on time, thus increasing the accuracy of determining the triage category, which will impact the treatment outcome of patients. ©2023 the author(s), published by De Gruyter. All rights reserved.