Schull M J, Redelmeier D A
Clinical Epidemiology Unit, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Ontario, Canada.
Acad Emerg Med. 2000 Jun;7(6):647-52. doi: 10.1111/j.1553-2712.2000.tb02038.x.
To estimate the benefit of routine electrocardiographic (ECG) telemetry monitoring on in-hospital cardiac arrest survival.
In a tertiary care hospital, all telemetry ward admissions and cardiac arrests occurring over a five-year period were reviewed. Ward location and survival to discharge were determined for all patients outside of critical care areas.
During the study period, 8,932 patients were admitted to the telemetry ward, and 20 suffered cardiac arrest (0.2%; 95% CI = 0.1 to 0.3). Telemetry monitors signaled the onset of cardiac arrest in only 56% (95% CI = 30 to 80) of monitored arrests. Three patients survived to discharge, and in two of these three patients the arrest onset was signaled by the monitor. This yields a monitor-signaled survival rate among telemetry ward patients of 0.02% (95% CI = 0 to 0.05). All survivors suffered significant arrhythmias prior to their cardiac arrests.
Cardiac arrest is an uncommon event among telemetry ward patients, and monitor-signaled survivors are extremely rare. Routine telemetry offers little cardiac arrest survival benefit to most monitored patients, and a more selective policy for telemetry use might safely avoid ECG monitoring for many patients.
评估常规心电图遥测监测对住院期间心脏骤停患者生存的益处。
在一家三级护理医院，回顾了五年期间所有遥测病房收治的患者及发生的心脏骤停情况。确定了重症监护区域以外所有患者的病房位置及出院生存率。
在研究期间，8932名患者入住遥测病房，20例发生心脏骤停（0.2%；95%置信区间=0.1至0.3）。遥测监测仪仅在56%（95%置信区间=30至80）的监测到的心脏骤停事件中发出了警报。3例患者存活至出院，其中2例患者的心脏骤停发作被监测仪发出警报。这使得遥测病房患者中监测仪发出警报的生存率为0.02%（95%置信区间=0至0.05）。所有幸存者在心脏骤停前均患有严重心律失常。
心脏骤停在遥测病房患者中是罕见事件，监测仪发出警报的幸存者极为罕见。常规遥测对大多数受监测患者几乎没有心脏骤停生存益处，更具选择性的遥测使用策略可能安全地避免对许多患者进行心电图监测。
