cliot (version 1.0.0)

adapt_cardiac_risk: ADAPT Protocol for Cardiac Event Risk

Description

Implements the 2-Hour Accelerated Diagnostic Protocol to Assess Patients with Chest Pain Symptoms (ADAPT). This protocol identifies low-risk patients who can be safely discharged from the Emergency Department within 2 hours.

To be classified as "Low Risk" (safe for discharge), a patient must meet ALL of the following criteria: 1. TIMI Score = 0. 2. No new ischemic changes on ECG. 3. Negative Troponin at 0 hours. 4. Negative Troponin at 2 hours.

Usage

adapt_cardiac_risk(timi_score, ekg_new_ischemia,
troponin_0h_positive, troponin_2h_positive)

Value

A list containing:

Risk_Category

"Low Risk" or "Not Low Risk".

MACE_Risk_30_Day

Estimated risk of Major Adverse Cardiac Events at 30 days.

Recommendation

Clinical guidance regarding discharge vs. observation.

Arguments

timi_score

Numeric. The patient's TIMI Risk Score for UA/NSTEMI (Range 0-7).

ekg_new_ischemia

Numeric (0 or 1). Presence of new ischemic changes on ECG. (1 = Yes, 0 = No).

troponin_0h_positive

Numeric (0 or 1). Baseline (0-hour) troponin result above the institutional cutoff. (1 = Positive, 0 = Negative).

troponin_2h_positive

Numeric (0 or 1). 2-hour troponin result above the institutional cutoff. (1 = Positive, 0 = Negative).

References

Than M, Cullen L, Aldous S, et al. 2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker: The ADAPT Trial. J Am Coll Cardiol. 2012;59(23):2091-2098. doi:10.1016/j.jacc.2012.02.035

Examples

# Example 1: Low Risk (Safe for discharge)
# TIMI 0, No EKG changes, Negative Troponins x2
adapt_cardiac_risk(0, 0, 0, 0)

# Example 2: Not Low Risk
# TIMI 1, No EKG changes, Negative Troponins x2
adapt_cardiac_risk(1, 0, 0, 0)

# Example 3: Not Low Risk
# TIMI 0, No EKG changes, Positive 2h Troponin
adapt_cardiac_risk(0, 0, 0, 1)