OBJECTIVES: Quantitative risk assessment in unstable @entity951 (UA) and @entity583 ( @entity583 ), by using cardiac risk scores, is recommended in international guidelines. However, a gap between recommended care and actual practice exists, as these instruments seem underused in practice. The present study aimed to determine the extent of cardiac risk score use and to study factors associated with lower or higher cardiac risk score use. SETTING: 13 hospitals throughout the Netherlands. @entity1 : A retrospective chart review of 1788 charts of @entity1 with UA and @entity583 , discharged in 2012. PRIMARY AND SECONDARY OUTCOMES: The extent of cardiac risk score use reflected in a documented risk score outcome in the @entity1 's chart. Factors associated with cardiac risk score use determined by generalised linear mixed models. RESULTS: In 57% (n=1019) of the charts, physicians documented the use of a cardiac risk score. Substantial variation between hospitals was observed (16.7-87%), although this variation could not be explained by the presence of on-site revascularisation facilities or a hospitals' teaching status. @entity28 @entity1 (OR=1.49; CI 95%1.03 to 2.15) and former smokers (OR=1.56; CI 95%1.15 to 2.11) were more likely to have a cardiac risk score documented. Risk scores were less likely to be used among @entity1 diagnosed with UA (OR=0.60; CI 95% 0.46 to 0.77), in-hospital resuscitation (OR=0.23; CI 95% 0.09 to 0.64), in-hospital @entity712 (OR=0.46; CI 95% 0.27 to 0.76) or @entity591 (OR=0.45; CI 95% 0.26 to 0.75). CONCLUSIONS: Despite recommendations in cardiac guidelines, the use of cardiac risk scores has not been fully implemented in Dutch practice. A substantial number of @entity1 did not have a cardiac risk score documented in their chart. Strategies to improve cardiac risk score use should pay special attention to @entity1 groups in which risk scores were less often documented, as these @entity1 may currently be undertreated.

A cross-sectional multicentre study of cardiac risk score use in the management of unstable @entity951 and XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PARTICIPANTS'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity28 :: ('MESH:D009765', 'Disease') :: ['Obese'] @entity591 :: ('MESH:D013610', 'Disease') :: ['tachycardia'] @entity951 :: ('MESH:D000787', 'Disease') :: ['angina'] @entity583 :: ('MESH:D009203', 'Disease') :: ['NSTEMI', 'non-ST-elevation myocardial infarction']
@entity583 :: (MESH:D009203,Disease) :: ['non-ST-elevation myocardial infarction']
