Abstract
Aim: ST-elevation myocardial infarction (STEMI), is a common cause of morbidity and mortality. Emergency departments (ED) have a very important role in the management of these patients. Prediction of mortality in STEMI is decisive in establishing therapeutic management to improve outcomes. This study aims to investigate whether triage in emergency departments early warning score (TREWS), modified early warning scoring, national early warning score2 (NEWS-2), and rapid emergency medicine score (REMS) scoring systems are as effective as thrombolysis in myocardial infarction (TIMI), Portuguese registry of acute coronary syndromes (ProACS), and Canadian acute coronary syndrome (C-ACS) in predicting the prognosis in patients diagnosed with STEMI.
Materials and Methods: Patients presenting to a tertiary emergency service in a single center between 01.07.2021 and 30.06.2022 and diagnosed with STEMI were prospectively analyzed. The mortality prediction performances of the patients’ measured scores in the first 24 hours and 30 days were evaluated.
Results: A total of 213 patients who met the criteria were included in the study. When the area under the curve values for the first 28-day mortality diagnosis were examined, the NEWS-2 [0.713 (0.574-0.852), p<0.05], REMS [0.768 (0.642-0.894), p<0.05], TREWS [0.823 (0.736- 0.911), p<0.001], TIMI [0.761 (0.646-0.876), p<0.05], ProACS [0.769 (0.670-0.868), p<0.05], and C-ACS [0.743 (0.601-0.885), p<0.05] were found to be significant.
Conclusion: The TREWS, NEWS-2 and REMS scores measured at admission were seen to be as effective as the TIMI, ProACS, and C-ACS scores commonly used by cardiologists in predicting the prognosis of STEMI patients presenting to the ED. Among all these scorings, we found that the TREWS showed the best performance. We think that the TREWS score can be used to predict the prognosis of STEMI patients.