A Clinical Score for Predicting the Paroxysmal Supraventricular Tachycardia’s Recurrence Risk; a Retrospective Cross-sectional Study
Issued Date
2023-01-01
Resource Type
eISSN
26454904
Scopus ID
2-s2.0-85199751934
Journal Title
Archives of Academic Emergency Medicine
Volume
11
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Archives of Academic Emergency Medicine Vol.11 No.1 (2023)
Suggested Citation
Yuksen C., Tienpratarn W., Promkul R., Jenpanitpong C., Watcharakitpaisan S., Yaithet J., Phonphom V. A Clinical Score for Predicting the Paroxysmal Supraventricular Tachycardia’s Recurrence Risk; a Retrospective Cross-sectional Study. Archives of Academic Emergency Medicine Vol.11 No.1 (2023). doi:10.22037/aaem.v11i1.1825 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/102027
Title
A Clinical Score for Predicting the Paroxysmal Supraventricular Tachycardia’s Recurrence Risk; a Retrospective Cross-sectional Study
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
Introduction: Identifying prognostic variables associated with the probability of recurrent paroxysmal supraventricular tachycardia (PSVT) would aid decision-making regarding disposition of the patients. This study aims to develop a clinical scoring system to predict PSVT recurrence after adenosine administration in the emergency department (ED). Methods: This retrospective cross-sectional study was conducted on patients who were referred to the emergency department of Ramathibodi Hospital, a university-affiliated super-tertiary care hospital in Bangkok, Thailand, with diagnosis of PSVT during a 10-year period from 01 January 2010 until 31 December 2020. The cases were divided into recurrent and non-recurrent PSVT based on the response to standard treatment and the independent predictors of recurrence were studied using multivariable logistic regression analysis. Results: 264 patients were diagnosed with PSVT and successfully converted by adenosine. 24 (9.1%) had recurrent PSVT, and 240 (90.9%) had no recurrent PSVT in the same ED visit. The risk of PSVT recurrence in ED corresponded with the history of hypertension (p = 0.059), valvular heart disease (p = 0.052), heart rate ≥100 (p = 0.012), and systolic blood pressure < 100 after electrocardiogram (ECG) converted to sinus rhythm (p = 0.022) and total dose of adenosine (p = 0.002). We developed a clinical prediction score of PSVT recurrence with an accuracy of 79.5%. A score of 0 (low risk), 1–2 (moderate risk), and > 2 (high risk) had a positive likelihood ratio (LR+) of 0.31, 0.56 and 2.33, respectively. Conclusion: It seems that, using the PSVT recurrence score we could screen the high-risk patients for PSVT recurrence (score>2) who need to be observed for at least 6-12 hours and receive cardiologist consultation in ED. In addition, the moderate and low-risk group (score 0-2) need to be observed for 1 hour and can be discharged fromED.