Sivaram C A, Summers J H, Ahmed N
Department of Veterans' Affairs Medical Center, Oklahoma City 73104, USA.
Clin Cardiol. 1998 Jul;21(7):503-5. doi: 10.1002/clc.4960210709.
Guidelines for the use of telemetry in hospitalized patients have been proposed by the American College of Cardiology (ACC). However, there have been only a few studies which have investigated the usefulness of these guidelines in clinical practice.
This study assessed the role of telemetry in the decision making process outside the critical care units.
The observational study, lasting 4 weeks, was conducted in the telemetry unit of a tertiary care teaching hospital and included 61 male patients (age range 40-61 years). They had been directly admitted to the telemetry unit or transferred from a critical care unit and were followed for as long as telemetry was active. Indication for telemetry and the contribution of telemetry to management decisions were assessed by a physician not involved in the care of the patient.
Cumulative number of telemetry days was 379 with a mean of 6.2 days per patient. Total number of telemetry events was 297. According to the ACC classification, 14 patients (22.9%) had class I indication, 21 patients (34.4%) had class II indication, and 26 patients (42.6%) had class III indication. Telemetry events were seen in 18.2% of class I patients, in 39.7% of class II patients, and in 42.1% of class III patients. Only 12 telemetry events (4%) resulted in patient management, with none belonging to class III.
Telemetry findings in patients outside the critical care units are not usually responsible for major therapeutic changes. The value of telemetry in such patients may be overrated.
美国心脏病学会（ACC）已提出住院患者使用遥测技术的指南。然而，仅有少数研究调查了这些指南在临床实践中的实用性。
本研究评估了遥测技术在重症监护病房以外的决策过程中的作用。
这项为期4周的观察性研究在一家三级护理教学医院的遥测病房进行，纳入了61名男性患者（年龄范围40 - 61岁）。他们直接入住遥测病房或从重症监护病房转入，在遥测技术启用期间一直接受随访。由一名未参与患者护理的医生评估遥测技术的指征以及遥测技术对管理决策的贡献。
遥测天数累计为379天，平均每位患者6.2天。遥测事件总数为297次。根据ACC分类，14名患者（22.9%）有I类指征，21名患者（34.4%）有II类指征，26名患者（42.6%）有III类指征。I类患者中18.2%出现遥测事件，II类患者中39.7%出现遥测事件，III类患者中42.1%出现遥测事件。仅有12次遥测事件（4%）导致了患者管理的改变，且没有一次属于III类。
重症监护病房以外患者的遥测结果通常不会导致重大治疗改变。遥测技术在此类患者中的价值可能被高估了。
