PRISM-TIMI Score - A Medical Record Review (v.3)
Research type
Research Study
Full title
Prehospital Risk Stratification using a Modified Thrombolysis in Myocardial Infarction (PRISM-TIMI) Score – A Medical Record Review
IRAS ID
159595
Contact name
Ashley Reed
Contact email
Sponsor organisation
St George's University of London
Clinicaltrials.gov Identifier
N/A, N/A
Research summary
A heart attack is when blood flow is limited or completely stopped from travelling through an artery in the heart, which provides blood and oxygen to the heart muscle itself. When blood stops reaching the heart muscle it stops working efficiently and if not salvaged quickly, may never work again. Conditions that limit blood flow to the heart are called acute coronary syndromes (ACS). The three main components are ST elevation myocardial infarction (STEMI), non ST-elevation myocardial infarction (NSTEMI) and unstable angina (UA). The last two cannot be differentiated between without blood tests, so prior to blood tests they are grouped and called non ST-elevation acute coronary syndromes (NSTEACS). STEMIs can be clearly identified on a heart trace (electrocardiogram – ECG). Paramedics frequently are the first medical clinicians to identify these patients. Once identified, STEMIs are quickly taken to a heart attack centre (HAC) for specialist treatment by a heart doctor.
The NSTEACS are harder to identify and have not been given as much attention as the STEMIs. The NSTEACS go to an emergency department (ED) where a doctor uses a risk stratification tool to predict the outcome of the patient. Based on the risk score the patient may remain in the ED for further care or some of the higher risk patients may attend a HAC and have similar treatment as the STEMI patients.
This research aims to use a novel prehospital NSTEACS risk stratification tool called the Modified Thrombolysis in Myocardial Infarction (MTIMI) score. Notes of patients identified by paramedics as NSTEACS, will be assessed with the ED or HAC medical notes to find out the patients final outcome. The MTIMI score will be assessed to determine if the MTIMI is a more accurate way at risk stratifying this patient group compared to paramedics’ current method.
REC name
London - Stanmore Research Ethics Committee
REC reference
14/LO/1526
Date of REC Opinion
12 Sep 2014
REC opinion
Favourable Opinion