Comparison of Triage Effectiveness Based on ESI and HEART Scale in Diagnosis of Outcome in Patients with Chest Pain

Chest pain is one of the common causes of emergency department visit, but only 25-15% of them are diagnosed with acute coronary syndrome (ACS). However, unexplained cases of ACS have led to high mortality rates. The aim of this study was to compare the effectiveness of ESI triage (Emergency Severity Index) and HEART scale (Chest Pain Diagnostic Scale) in detecting the outcome of patients with complaints of chest pain.

This descriptive study was performed on 200 patients with chest pain in emergency department of selected hospitals of Shahid Beheshti University of Medical Sciences in 2017. The ESI triage form, HEART and demographic information were completed for all patients. Six weeks later patients were re-evaluated in terms of heart problems.

The compliance of the ESI triage and HEART scale in the high-risk group was 27.9% (24 people), the middle-risk group was 79% (62 people) and the low-risk group (30.6%) (11 people). In general, comparing the total scores, these two scales were consistent with 48%. Also, after considering the cut-off point 4.5, the sensitivity 85% and the specificity 89% with a 95% confidence interval for the HEART scale and sensitivity 95%, and the specificity 25% with a 95% confidence interval was found for the ESI triage.

According to the results of this study, despite its wide range, the ESI triage has shown a poor performance over the HEART scale. Therefore, the use of the combined HEART triage ESI scale can be very helpful.