Use of the simplified Selvester score

Oct 13, 2025 by wbrum.org 21 views

The Role of the Simplified Selvester Score as a Predictor of the Success of Fibrinolytic in Patients with Myocardium Infarction of the ST Segment Elevation

Introduction

Myocardium infarction of the ST (IMAEST) segment is a medical emergency that requires prompt and effective treatment. In many developing countries, fibrinolytic therapy is still the primary treatment option for patients with IMAEST. However, despite its widespread use, a significant proportion of patients, ranging from 25-50%, fail to achieve successful reperfusion after receiving fibrinolytic therapy. This highlights the need for a reliable predictor of treatment success to identify patients at risk of failure and enable healthcare providers to make informed decisions about alternative treatment options.

The Importance of Predicting Fibrinolytic Success

Predicting the success of fibrinolytic therapy is crucial in the management of IMAEST patients. A successful reperfusion can significantly improve patient outcomes, reduce morbidity and mortality, and enhance quality of life. Conversely, treatment failure can lead to prolonged hospital stays, increased healthcare costs, and a higher risk of complications. Therefore, identifying patients who are likely to benefit from fibrinolytic therapy is essential to optimize treatment outcomes.

The Simplified Selvester Score: A Potential Predictor of Fibrinolytic Success

The Selvester score is a widely used electrocardiographic (ECG) scoring system that assesses the extent of myocardial damage in patients with IMAEST. The simplified Selvester score is a modified version of the original score that is easier to calculate and interpret. This study aims to investigate the relationship between the simplified Selvester score and the success of fibrinolytic therapy in patients with IMAEST.

Research Methods

This retrospective study involved 53 patients with IMAEST who received fibrinolytic therapy using streptokinase. The researchers analyzed the relationship between the simplified Selvester score and the success of fibrinolytic therapy using various statistical tests, including the Receiver Operating Characteristic (ROC) curve, Chi-Square, Fisher's EXACT, and logistical regression tests. The cutoff score value was determined using the ROC curve, and the P <0.05 value was considered significant.

Research Results

The results of this study showed that patients who achieved successful reperfusion had a lower Selvester score (2.3 ± 1.6 vs 5.1 ± 1.7; p = 0.001). The cutoff value obtained for the simplified Selvester score was <3.5. The logistical regression test also showed that the simplified Selvester score with a value of <3.5 was an independent factor that could predict the success of fibrinolytic therapy (p = 0.004; OR 6.8; 95% CI: 1,511 - 37,065).

Additional Analysis and Explanation

These findings have significant implications for clinical practice. By knowing that a lower Selvester score correlates with the success of fibrinolytic therapy, healthcare providers can more easily evaluate and determine appropriate care for patients with IMAEST. The simplified Selvester score offers a practical and fast way to assess a patient's prognosis and assist in making better therapeutic decisions.

In addition, the relationship between the Selvester score and the success of reperfusion can help the medical team improve treatment efficiency. If a patient demonstrates a Selvester score above 3.5, healthcare providers can consider alternative reperfusion options that may be more effective, such as percutaneous intervention. Thus, the use of simplified Selvester scores as a prediction tool can improve treatment results and enhance the quality of life of patients with IMAEST.

Conclusion

The simplified Selvester score can be relied upon as an independent predictor of the success of fibrinolytic in patients with IMAEST. This study emphasizes the importance of using this score in daily clinical practice, especially in the context of developing countries where fibrinolytic is still the first choice. By utilizing this tool, healthcare providers can increase treatment results and reduce therapeutic failure rates.

Recommendations

Based on the findings of this study, the following recommendations can be made:

Use of the simplified Selvester score: Healthcare providers should use the simplified Selvester score as a predictor of fibrinolytic success in patients with IMAEST.
Alternative reperfusion options: Patients with a Selvester score above 3.5 should be considered for alternative reperfusion options, such as percutaneous intervention.
Improved treatment efficiency: The use of the simplified Selvester score can help improve treatment efficiency by identifying patients who are likely to benefit from fibrinolytic therapy.
Further research: Further research is needed to validate the findings of this study and explore the use of the simplified Selvester score in other clinical settings.

Limitations

This study has several limitations, including:

Small sample size: The study involved a small sample size of 53 patients.
Retrospective design: The study had a retrospective design, which may limit the generalizability of the findings.
Limited data: The study only analyzed data from patients who received fibrinolytic therapy, which may not be representative of all patients with IMAEST.

Future Directions

Future studies should aim to:

Validate the findings: Validate the findings of this study using larger sample sizes and prospective designs.
Explore the use of the simplified Selvester score: Explore the use of the simplified Selvester score in other clinical settings, such as acute coronary syndrome and heart failure.
Develop a predictive model: Develop a predictive model that incorporates the simplified Selvester score and other clinical variables to predict fibrinolytic success.
Frequently Asked Questions (FAQs) about the Simplified Selvester Score

Q: What is the simplified Selvester score?

A: The simplified Selvester score is a modified version of the original Selvester score, which is a widely used electrocardiographic (ECG) scoring system that assesses the extent of myocardial damage in patients with myocardium infarction of the ST segment elevation (IMAEST).

Q: How is the simplified Selvester score calculated?

A: The simplified Selvester score is calculated by adding up the scores for various ECG changes, such as Q waves, R waves, and S waves, in different leads. The score ranges from 0 to 10, with higher scores indicating more extensive myocardial damage.

Q: What is the cutoff value for the simplified Selvester score?

A: The cutoff value for the simplified Selvester score is <3.5. Patients with a score below 3.5 are considered to be at lower risk of treatment failure and may be more likely to benefit from fibrinolytic therapy.

Q: How does the simplified Selvester score predict fibrinolytic success?

A: The simplified Selvester score predicts fibrinolytic success by identifying patients who are at lower risk of treatment failure. Patients with a lower Selvester score are more likely to achieve successful reperfusion and have better outcomes.

Q: Can the simplified Selvester score be used in other clinical settings?

A: Yes, the simplified Selvester score can be used in other clinical settings, such as acute coronary syndrome and heart failure. However, further research is needed to validate its use in these settings.

Q: What are the limitations of the simplified Selvester score?

A: The simplified Selvester score has several limitations, including:

Small sample size: The study involved a small sample size of 53 patients.
Retrospective design: The study had a retrospective design, which may limit the generalizability of the findings.
Limited data: The study only analyzed data from patients who received fibrinolytic therapy, which may not be representative of all patients with IMAEST.

Q: How can the simplified Selvester score be used in clinical practice?

A: The simplified Selvester score can be used in clinical practice to:

Identify patients at lower risk of treatment failure: Patients with a lower Selvester score are more likely to benefit from fibrinolytic therapy.
Make informed decisions about alternative reperfusion options: Patients with a higher Selvester score may be considered for alternative reperfusion options, such as percutaneous intervention.
Improve treatment efficiency: The use of the simplified Selvester score can help improve treatment efficiency by identifying patients who are likely to benefit from fibrinolytic therapy.

Q: What are the future directions for research on the simplified Selvester score?

A: Future research should aim to:

Validate the findings: Validate the findings of this study using larger sample sizes and prospective designs.
Explore the use of the simplified Selvester score: Explore the use of the simplified Selvester score in other clinical settings, such as acute coronary syndrome and heart failure.
Develop a predictive model: Develop a predictive model that incorporates the simplified Selvester score and other clinical variables to predict fibrinolytic success.

Q: What are the implications of this study for patients with IMAEST?

A: This study has significant implications for patients with IMAEST, as it provides a new tool for predicting fibrinolytic success. Patients with a lower Selvester score are more likely to benefit from fibrinolytic therapy, which can improve treatment outcomes and reduce morbidity and mortality.