Critical Care Nursing
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Browsing Critical Care Nursing by Author "Ahmed Adnan Zamel"
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- ItemCOMPARING THE ACCURACY OF THROMBOLYSIS IN MYOCARDIAL INFARCTION SCORE AND THE GLOBAL REGISTRY OF ACUTE CORONARY EVENTS SCORE IN PREDICTING IN-HOSPITAL, SHORT AND LONG-TERM OUTCOMES AMONG PATIENTS WITH ACUTE CORONARY SYNDROME(2023-09-20) Ahmed Adnan ZamelBackground: The Thrombolysis in Myocardial Infarction (TIMI) score and the Global Registry of Acute Coronary Events (GRACE) score are frequently utilized as risk assessment instruments within the discipline of cardiology. Short-term acute coronary syndrome (ACS) outcomes are immediate treatment and survival for one months while long-term outcomes are recurrence, lifestyle-focused prevention and mortality risk for 6 months from admissions hospitals. The TIMI score is used to predict unfavorable outcomes, whilst the GRACE score to estimate death rates and significant cardiovascular events in ACS patients. Aim: This study aimed to compare the accuracy of TIMI and GRACE scoring systems in predicting in-hospital, short-term, and long-term outcomes amongst ACS patients. Method: A retrospective study was conducted from June to December 2022. The sample size was 250 people. This study focused on ACS patients who got admitted to An-Najah National University Hospital (NNUH). The response rate was 92.6%. Statistical Package for Social Science (SPSS) was used to analyze the data. Results: The findings indicated that 228 patients (91.2%) survived and 22 (8.8%) died. The GRACE score exhibited remarkable accuracy of diagnosis in prediction of survival among participants. This is supported by the observation of a specificity, sensitivity, Positive Predictive Value (PPV), negative predictive value (NPV), and total accuracy of 100%. The receiver operating characteristic (ROC) curve demonstrated exceptional differentiation between survivors and those who have died, as shown by an area under the curve (AUC) value of 1.000. In contrast, TIMI score accuracy was less robust. The study of the ROC curve yielded an AUC of 0.739 (P <0.001). The sensitivity and specificity were 68.2% and 63.6% respectively. The PPV and NPV were 15.3% and 95.4%, correspondingly. Additionally, the total accuracy for prediction and diagnosing the survival status was 64.0%. Conclusion: The GRACE score demonstrated excellent diagnostic accuracy in predicting patient survival status, with perfect sensitivity, specificity, PPV, NPV, and overall accuracy. While, the TIMI score showed comparatively weaker accuracy, with lower sensitivity, specificity, PPV, NPV, and overall accuracy. Keywords: Acute Coronary Events; Acute Coronary Events Score; An-Najah National University Hospital; Predicting in-Hospital; Thrombolysis in Myocardial Infarction.