Application Value of NLR,PLR,LMR,HEART score,and POCT in Early Warning and Accurate Graded Diagnosis of High-Risk Chest Pain in Emergency Medicine

Objective: To evaluate the application value of neutrophils/lymphocytes (NLR), platelets/lymphocytes (PLR), lymphocytes/monocytes (LMR), HEART (history, electrocardiogram, age, risk factors, and troponin) score, and point-of- care testing (POCT) in the early warning and precise diagnosis of high-risk chest pain in emergency medicine. Methods: A total of 157 patients with acute chest pain who were admitted to the emergency department and chest pain treatment unit of our hospital between August 2022 and September 2023 were selected. Rapid testing of bedside myocardial markers (ultrasensitive troponin (hs-cTnI), myoglobin (MYO), creatine kinase isoenzyme (CK-MB), D-dimer (D-Dimer), and N-terminal B-type natriuretic peptide precursor (NT-proBNP)) was performed on the patients using a POCT device (ThermoKing BioMQ60proB). A HEART score was used to classify the patients into low (n = 53), intermediate (n = 59), and high-risk (n = 45) groups, and the NLR, PLR, and LMR were calculated. The NLR, PLR, and LMR values were compared among the three groups of patients, and the optimal cutoff values as well as sensitivity and specificity were determined based on receiver operating characteristic (ROC) analysis. Results: The HEART scores of patients in the low-risk, intermediate-risk, and high-risk groups were (2.72 ± 0.24), (4.75 ± 0.56), and (5.32 ± 0.73) respectively, and the differences were statistically significant (P < 0.05). Compared with the low-risk group, the intermediate-risk group and high-risk group had a significantly higher NLR and PLR, and a significantly lower LMR;the high-risk group had higher NLR and PLR and lower values of LMR as compared to the other two groups, and the difference was statistically significant (P < 0.05). The ROC curves suggested that the area under the curve, sensitivity, and specificity of the combined diagnosis of NLR, PLR, LMR, HEART score, and POCT were greater than those of LR, PLR, and LMR with HEART score and POCT alone. Conclusion: The combined application of NLR, PLR, LMR, HEART score, and POCT has significant application value in the early warning and precise diagnosis of emergency high-risk chest pain. It provides a more simple, easy-to-access, and efficient assessment index for the clinical prediction and treatment of emergency high- risk chest pain.

Optimization of emergency nursing process for the rescue of patients with chest pain in the emergency department

Background The occurrence factors of emergency chest pain are relatively complex,and the progression of the condition is fast.Within a short period of time,the condition can worsen significantly,resulting in a higher mortality rate.Therefore,conducting proactive and effective emergency rescue work within a short period of time can significantly improve the success rate of patient resuscitation.Therefore,this study will focus on exploring the research on optimizing the emergency nursing process for the rescue effectiveness of emergency chest pain patients.Methods 82 patients with emergency chest pain admitted to our hospital from January 2022 to January 2023 were selected as the subjects of this study.They were evenly divided into observation group and control group by random number table method,with 41 cases in each group.The control group was given routine nursing,and the observation group was given optimized emergency nursing process.The rescue effect,rescue efficiency,adverse events and nursing quality of the two groups were compared.Results The success rate of rescue was 100.00%in the observation group and 90.24%in the control group,which was significantly higher than that of the control group(P<0.05).The duration of rescue,emergency stay time and hospitalization time in the observation group was lower than that in the control group(P<0.05).The proportion of patients with shock,arrhythmia and heart failure was 0.00%in the observation group,which was lower than the 9.76%in the control group(P<0.05),and the nursing quality scores of emergency order and basic nursing in the observation group were higher than those in the control group(P<0.05).Conclusionss Optimized emergency nursing process can improve the rescue success rate of patients with chest pain in the emergency department,improve the rescue work efficiency,speed up the treatment of patients,and significantly reduce adverse events,which is worthy of popularization and application.