Use of pain scales in emergency patients due to complaints of chest pain in early diagnosis

Introduction: Pain rating scales have a fundamental place in clinical practice. In this study; We aimed to evaluate the pain scales in patients with chest pain and compared it with routine diagnostic methods to investigate whether the pain scale could be used in early diagnosis. Material and Method: This study was conducted at the Sakarya University Training and Research Hospital Emergency Medicine Clinic. 337 patients volunteered for this study. Patient's chest pain anamnesis, vital findings, laboratory data, ECG findings, final diagnosis, results and information including the Facial and Numeric Pain Scale was recorded into the patient assessment form. Results: 188 patients had acute coronary syndrome (68 STEMI, 75 NSTEMI ve 45 USAP) and 149 patients had noncardiac chest pain. The pain characteristics of the cases, 181 (%53,7) of the patients say that they perceive pain in the form of pressure and reported that he had deep-seated pain in his left chest, respectively. In terms of Facial Pain Scale, 6 (%1,8) patients had no pain, 17 (%5) patients had a limit of 9-10. Besides from Numerical Pain Scale it was determined that there was no pain in one patient (%0,3), but it was at the limit of 7-10 in the other 167 (%49,7) patients. It was determined that the numerical pain scale was significantly higher when feeling pain in the pressure type pain (p=0,005). According to the last diagnosis; The numerical pain scale in STEMI patients was found to be significantly higher than noncardiac patients, NSTEMI and USAP patients (p<0,001, p=0.013, p<0,001), but no significant difference was found between the other groups (p>0.05). We detected a significant positive, low grade relationship between numerical pain scale and age, duration of pain (min), WBC and NEU variables. Contrariwise there were a significant negative low-grade relationship between numerical pain scale and pain initiation time, number of pain attacks, eGFR parameters. The facial pain scale was significantly higher in those with pressure type chest pain (P<0,001). It was determined that the facial pain scale in STEMI-detected patients was significantly higher than the other patient groups (P<0.001, P=0.008, P<0.001), but there is no significant difference between the groups according to the other recent diagnosis (P>0.05). There was a positive and low correlation between the variables of age, duration of pain (min), fever, WBC, MPV, NEU, NLR, URE, creatinine and hsTnl with facial pain scale, there was a negative and low-grade relationship between eGFR. Conclusion: Numerical and Facial Pain Scales can be used for differential diagnosis of the STEMI patients from other causes of the chest pain. Keywords: Chest Pain, Acute Coronary Syndrome, Numeric Pain Rating Scales, Facial Pain Scales.