Identification and Prognostication in Acute Coronary Syndromes using Multiple Physiological Scoring Systems

This study aimed to evaluate the relative effectiveness of four different chest pain risk stratification tools: the Shock Index (SI), the Age Shock Index (ASI), the Modified Shock Index (MSI), and the Thrombolysis in Myocardial Infarction risk index (TRI). The aim of the study was to validate the use of these tools in the ED setting as an indicator of acute chest pain severity.

The study was done retrospectively on a cohort of 420 people presenting to the ED of Liverpool Hospital. Calculations were carried out on the vital signs, as collected from eMR FirstNet, and compared with the eventual ED diagnosis for analysis of correlation. It was found that for discrimination of a serious diagnosis, all four models were of some use with a high AUC (>0.7).

The study concluded that the four risk indexes under consideration may be of use in the rapid stratification of chest pain patients presenting to ED. However, it was noted because of other limitations such as the access of paper records and the small sample size of this exploratory research, further investigation will be needed to fully assess the effectiveness of these risk scores.