Prior reports have shown that one specific model, the Thrombolysis in Myocardial Infarction (TIMI) risk score, has been found to be predictive of the severity of the vascular disease making it a good tool to predict the potential of coronary circulation involvement in chest pain cases. Multiple predictor models have been used by physicians over the years in order to risk stratify patient populations to warrant further workup.

In rural hospitals, where resources and specialty services are limited, accurate risk stratification is of essence in order to optimize utilization of limited resources. This is consistent with the postulated null hypothesis: that there is no significant difference between the two surgery groups with respect to the mean/median TIMI score.Ĭonclusion: There was no statistical difference between high and low TIMI score in the intervention of unstable angina/non-ST elevated myocardial infarctions (UA/NSTEMI) in a rural hospital.Ĭhest pain accounts for nearly 7.6 million annual visits in the USA and is one of the most common diagnoses that warrants an admission in the hospital. Results: Formal statistical analysis using T-test as well as Wilcoxon rank-sum test comparing the two groups showed p = 0.34 for T-test and p = 0.60 for Wilcoxon rank-sum test. T-test and Wilcoxon rank-sum analysis were performed through SPSS statistical analysis. A null hypothesis was postulated that there was no significant difference between the two groups with regard to prevalence of either positive stress test or evidence of obstructive coronary disease following coronary angiography. The 246 remaining subjects were classified into two groups, those with TIMI 0–2 compared with those having TIMI ≥ 3. A total of 153 subjects who were transferred out to a larger facility, transitioned to comfort care, refused intervention, or passed away were excluded from the study. A total of 399 subjects who underwent left heart catheterization and/or stress testing were recruited for this study. Methods: A retrospective chart review study in a rural hospital was conducted for subjects that received left heart catheterizations, exercise stress tests, or chemical stress tests for a diagnosis of UA/NSTEMI. The objective of this study was to assess the reliability of TIMI score as early risk stratification in patients with unstable angina/non-ST elevated myocardial infarctions (UA/NSTEMI) in rural hospital. An estimated number 25,000 deaths than their urban counterparts, which coincide with a TIMI risk score of ≥3, potentially limit the utility of the TIMI risk score in risk stratification in rural catherization laboratories. As per CDC study in 2014, Americans living in rural areas are more likely to die from leading causes such as cardiovascular diseases. A TIMI risk score ≥3 recommends early invasive management with cardiac angiography and revascularization. A higher score implies a higher likelihood of adverse cardiac events and/or risk of mortality. It is composed of seven factors and if present, each factor contributes a value of one point toward the TIMI risk score, making it a simple tool that does not require differential weights for each factor. Background: The Thrombolysis in Myocardial Infarction (TIMI) score is considered a method for early risk stratification in patients with unstable angina/non-ST elevated myocardial infarctions (UA/NSTEMI).

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