Pérez CJA, Mérigo AC, Montoya GC, Hernández FKS

Idioma: Español
Referencias bibliográficas: 22
Paginas: 14-19
Archivo PDF: 223.55 Kb.

RESUMEN

Introducción: Las unidades de dolor torácico son una herramienta útil en urgencias; su objetivo principal es la admisión fácil y expedita de los pacientes. Las escalas de riesgo PRETEST son evaluaciones que detectan pacientes con bajo riesgo de padecer un síndrome coronario. Objetivos: Determinar la efectividad de la escala de riesgo PRETEST y troponina I como rule-out (descarte) para detectar a pacientes con bajo riesgo de síndrome coronario agudo. Material y métodos: Fueron evaluados pacientes con dolor torácico en el Servicio de Urgencias del Centro Médico ABC; se obtuvieron datos como tipo de dolor, edad, género y troponina. Utilizando el formato de «unidad de dolor torácico», se determinó la escala PRETEST y troponina I. Se consultó el sistema TIMSA/ONBASE para confirmar diagnósticos y se calcularon la sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo y riesgo relativo. Resultados: Se evaluaron 114 pacientes, 75.4% fueron hombres y 24.6% mujeres; 21.9% se presentaron con dolor típico. La escala PRETEST tuvo una sensibilidad de 38%, con una especificidad de 93.8%, un valor predictivo positivo de 82.6% y un valor predictivo negativo de 65.9%, con una p ‹ 0.05. El acumulado de troponina I y PRETEST tuvo una especificidad del 100%. Conclusiones: La escala PRETEST representa una ventaja en la evaluación de pacientes con dolor torácico y sospecha de síndrome coronario agudo.

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