Validation of the HAR Score for Prioritization of Patients Calling the Emergency Medical Service for Chest Pain by Emergency Call Dispatcher (Reg-HAR)

Centre Hospitalier le Mans

Status

Not yet enrolling

Conditions

Chest Pain

Treatments

Other: follow up call

Study type

Observational

Funder types

Other

Identifiers

NCT06859021

CHM-2024-S01-08

Details and patient eligibility

About

The lifetime prevalence of chest pain in the general population is 20-40%. The etiologies to be evoked from the outset of management are those of cardiovascular origin, such as acute coronary syndrome (ACS) and pulmonary embolism. ACS is responsible for almost 20% of deaths. Delay in treatment is a major prognostic factor, given the importance of coronary reperfusion.

In France, one of the first contacts with the healthcare system is the medical regulation assistant (MRA) at the Centre 15. His or her role is to prioritize the call according to the identification of immediate signs of seriousness, and if necessary, to decide autonomously to send a rescue team before medical regulation. Depending on the reason for the call and any signs of seriousness, it prioritizes the call according to the expected response time. In line with current recommendations, all calls for chest pain should be answered by an emergency medical dispatcher (EMR) within 5 minutes. However, 60-90% of chest pain calls are not of cardiovascular origin. Their prioritization could therefore be re-qualified for longer response times.

Given the frequency of this type of call, a more efficient MRA referral strategy is needed. To achieve this, decision-support tools would be essential.

The performance of the HAR (History, Age and Risk Factors) score has been recently explored, derived from the HEART score, in a previous single-center prospective study in 2019. It stratifies the risk of a major cardiovascular event (MCE) into low (0 or 1 point), intermediate (2 or 3 points) or high (4, 5 or 6 points).

Investigator's hypothesis is that the HAR score could be entrusted to MRA, to enable them to optimize the prioritization of patients calling with non-traumatic chest pain, by qualifying low-risk chest pain calls on the one hand, which could be prioritized in P2 SNP, and high-risk calls on the other, making it possible to anticipate the dispatch of an emergency service.

Enrollment

796 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patient of legal age (≥ 18 years)
Calling Center 15 from 49, 72 or 37
Expressing non-traumatic chest pain, even if this is not the main reason for seeking help.

Exclusion criteria

Treatment in departments other than 49, 72 and 37
Taken in charge in an emergency department of a private facility in the 49, 72 and 37 départements
Poor understanding of the French language
Non-affiliated or non-beneficiary of a social security scheme
Person deprived of liberty by judicial or administrative decision
Person under forced psychiatric care
Person subject to a legal protection measure
Person unable to express his/her non-opposition.
Follow-up at Day 30 impossible for any reason
Person having expressed his/her opposition to the collection of his/her data.