cliot (version 1.0.0)

vancouver_chest_pain_rule: Vancouver Chest Pain Rule

Description

Applies the Vancouver Chest Pain Rule algorithm to identify patients with chest pain who are at low risk for Acute Coronary Syndrome (ACS) and can be safely discharged. The rule utilizes a decision tree based on ECG findings, history, age, and pain characteristics.

Usage

vancouver_chest_pain_rule(age, prior_acs_nitrate_use, ecg_st_depression,
                          ecg_non_specific_repolarization, troponin_elevated,
                          pain_worse_palpation)

Value

A list containing:

Result

Clinical interpretation (Low Risk vs Not Low Risk).

Risk_Category

Categorical risk assessment.

Arguments

age

Numeric. Patient age in years.

prior_acs_nitrate_use

Numeric (0 or 1). Does the patient have a prior history of ACS or use nitrates? (1 = Yes).

ecg_st_depression

Numeric (0 or 1). Presence of ST-segment depression (> 0.5 mm) on ECG? (1 = Yes).

ecg_non_specific_repolarization

Numeric (0 or 1). Presence of non-specific repolarization changes on ECG? (1 = Yes).

troponin_elevated

Numeric (0 or 1). Is the troponin level elevated (positive) at 0 or 2 hours? (1 = Yes).

pain_worse_palpation

Numeric (0 or 1). Does palpation reproduce the pain? (1 = Yes).

References

Cullen L, Greenslade JH, Than M, et al. Validation of the Vancouver Chest Pain Rule using troponin as the only biomarker: a prospective cohort study. Am J Emerg Med. 2014;32(2):114-121. doi:10.1016/j.ajem.2013.10.021

Examples

# Example 1: Low Risk (No Hx, Age < 50)
vancouver_chest_pain_rule(40, 0, 0, 0, 0, 0)

# Example 2: Not Low Risk (Age 60, No reproducible pain)
vancouver_chest_pain_rule(60, 0, 0, 0, 0, 0)

# Example 3: Low Risk (Hx ACS, but pain reproducible)
vancouver_chest_pain_rule(60, 1, 0, 0, 0, 1)