vancouver_chest_pain_rule: Vancouver Chest Pain Rule

In cliot: Clinical Indices and Outcomes Tools

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)

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).

Value

A list containing:

Result	Clinical interpretation (Low Risk vs Not Low Risk).
Risk_Category	Categorical risk assessment.

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)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.