Curry J Paul, Hanson C William, Russell Michael W, Hanna Cheryl, Devine Gayle, Ochroch E Andrew
*Department of Anesthesiology and Critical Care, Hoag Memorial Presbyterian Hospital Newport Beach, CA, and the †Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA.
Anesth Analg. 2003 Nov;97(5):1483-1487. doi: 10.1213/01.ANE.0000081720.49358.53.
The purpose of this study was to determine if rates of telemetry events differ between patients whose monitoring is appropriately "indicated" versus "not indicated" by systematically applying rigorous criteria for appropriateness of electrocardiogram (ECG) telemetry usage. We performed a retrospective cohort study on 1097 telemetry admissions between January 1, 2000 and March 31, 2000. A convenience sample of 218 patients generated 236 telemetry admissions. One-hundred-sixty-two arrhythmic events were detected during 400 "indicated" telemetry days. Nine arrhythmic events were detected during 345 "not indicated" telemetry days. The relative rate for arrhythmic events was significantly different, at P < 0.0001, with the incidence rate ratio of 15 indicating a very large effect size. Consequently, current use of ECG telemetry may not be optimal, and a prospective analysis of the application of rigorous indications for ECG telemetry needs to be undertaken.
The application of standard criteria to electrocardiogram telemetry admissions found that the majority of abnormal heart rhythms were found when patients met appropriate criteria.
本研究的目的是通过系统应用心电图（ECG）遥测使用适当性的严格标准，确定监测“适当指征”与“无指征”的患者之间遥测事件发生率是否存在差异。我们对2000年1月1日至2000年3月31日期间的1097例遥测入院病例进行了一项回顾性队列研究。218例患者的便利样本产生了236例遥测入院病例。在400个“有指征”的遥测日期间检测到162例心律失常事件。在345个“无指征”的遥测日期间检测到9例心律失常事件。心律失常事件的相对发生率有显著差异，P<0.0001，发病率比为15，表明效应量非常大。因此，目前ECG遥测的使用可能并非最佳，需要对ECG遥测严格指征的应用进行前瞻性分析。
对心电图遥测入院病例应用标准标准发现，当患者符合适当标准时，大多数异常心律被发现。
