Scalvini S, Zanelli E, Domenighini D, Massarelli G, Zampini P, Giordano A, Glisenti F
Divisione di Cardiologia, Fondazione Salvatore Maugeri, IRCCS, Gussago (BS), Ospedale di Vallecamonica, Esine, BS.
Cardiologia. 1999 Oct;44(10):921-4.
Cardiovascular diseases are the leading cause of morbidity and mortality in Western countries and represent, in terms of diagnostic and treatment measures, a large amount of health care expenses. A telecardiology service may offer to general practitioners, in real time, a useful diagnostic tool and the possibility of an accurate screening of patients with suspected ischemic heart disease.
From February to July 1998, in the provinces of Bergamo and Brescia (Italy), 178 general practitioners received a portable Card Guard 7100 electrocardiographer transferring, by a mobile or fixed telephone, a 12 lead ECG to a receiving station, where a cardiologist was available for the reporting and interactive teleconsultation.
During the first 6 months a total 2800 calls took place. Due to incompleteness of requested data only 2254 traces, corresponding to 2254 subjects (mean age 63 +/- 18 years) were entered in the study. In 27% of patients (n = 609) there was a history of systemic hypertension, in 12.5% (n = 283) there was a history of coronary artery disease, and in 38% (n = 834) there was no history of cardiovascular diseases. At the time of ECG recording, 42% of patients (n = 949) were symptomatic: more common symptoms were chest pain (39%), dyspnea (23%), palpitation (19%), dizziness or faint (10%), and asthenia (9%). No action was suggested by cardiologists in 74% of cases. Of the remaining patients, 16% (n = 92) were referred to the Emergency Department, 27% (n = 158) were offered further diagnostic tests as an out patient, and 56% (n = 328) were started on medication or had their treatment changed.
A telecardiology system provides a useful support to general practitioners in the management, in real time, of patients with cardiovascular conditions, and possibly contributes to optimization of health care costs in terms of appropriateness of hospital admissions and diagnostic tests.
心血管疾病是西方国家发病和死亡的主要原因，就诊断和治疗措施而言，代表了大量的医疗保健费用。远程心脏病学服务可以实时为全科医生提供一种有用的诊断工具，并有可能对疑似缺血性心脏病患者进行准确筛查。
1998年2月至7月，在意大利贝加莫省和布雷西亚省，178名全科医生收到了一台便携式Card Guard 7100心电图仪，通过移动电话或固定电话将12导联心电图传输到一个接收站，那里有一名心脏病专家进行报告和交互式远程会诊。
在最初的6个月里，总共进行了2800次呼叫。由于所要求数据不完整，只有2254条记录（对应2254名受试者，平均年龄63±18岁）被纳入研究。27%的患者（n = 609）有系统性高血压病史，12.5%（n = 283）有冠状动脉疾病病史，38%（n = 834）没有心血管疾病病史。在进行心电图记录时，42%的患者（n = 949）有症状：较常见的症状是胸痛（39%）、呼吸困难（23%）、心悸（19%）、头晕或昏厥（10%）以及乏力（9%）。心脏病专家在74%的病例中未提出任何行动建议。在其余患者中，16%（n = 92）被转诊至急诊科，27%（n = 158）作为门诊患者接受进一步诊断检查，56%（n = 328）开始用药或改变治疗方案。
远程心脏病学系统为全科医生实时管理心血管疾病患者提供了有用的支持，并可能在住院和诊断检查的合理性方面有助于优化医疗保健成本。
Zotero 插件