Coronarographies en dehors des heures ouvrables: evolution des indications. [Out of hours coronary angiography: changing indications]

Details

Serval ID
serval:BIB_759B710B300E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Coronarographies en dehors des heures ouvrables: evolution des indications. [Out of hours coronary angiography: changing indications]
Journal
Archives des Maladies du Coeur et des Vaisseaux
Author(s)
Berger  A., Stauffer  J. C., Schluter  L., Vogt  P., Seydoux  Ch, Delabays  A., De Benedetti  E., Kappenberger  L., Eeckhout  E.
ISSN
0003-9683 (Print)
Publication state
Published
Issued date
06/2002
Volume
95
Number
6
Pages
553-9
Notes
English Abstract
Journal Article --- Old month value: Jun
Abstract
The authors have recently demonstrated that 13% of indications for cardiac catheterisation performed "after hours" (week ends, holidays or from 6 pm to 7 am) are Class III of the AHA/ACC recommendations (i.e. indications not based on recognised medical evidence). In order to limit procedures performed for these unrecognised indications, a consensus of experts has defined a number of local recommendations. The aim of this paper was to study the impact of these recommendations on the indications of "out of hours" cardiac catheterisation. Two patient populations were identified and compared with respect to these recommendations. The first group comprised 157 consecutive patients treated between 1993 and 1994 (average age 58 +/- 13 years; 35% females) and the second one of 148 consecutive patients treated from 1998 to 1999 (average age 57 +/- 13 years; 25% females). The local recommendations were respected in 61% of cases and not applied in 39% of cases. This was a satisfactory result in view of the fact that the local recommendations are more restrictive than international guidelines as they cover emergency indications. In the second group of patients, there were no AHA/ACC Class III indications (30% Class I, 6% Class IIa and 3% Class IIb). There was a significant increase in the number of primary angioplasties for acute myocardial infarction (27 vs 2%; p < 0.001) and an expected reduction in salvage angioplasties (17 vs 7%; p < 0.01). There was no significant change in the indications in patients with unstable angina, the European and American guidelines having been published at the end of data collection. Therefore, the introduction of recommendations for out of hours cardiac catheterisation has limited the number performed for unrecognised indications in favour of evidence based procedures.
Keywords
Adult Aged Angina, Unstable/*therapy Emergency Treatment Evidence-Based Medicine Female *Guideline Adherence Heart Catheterization/*statistics & numerical data Humans Male Middle Aged *Practice Guidelines Retrospective Studies Time Factors
Pubmed
Web of science
Create date
28/01/2008 9:48
Last modification date
20/08/2019 14:33
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