Krasuski R A, Hartley L H, Lee T H, Polanczyk C A, Fleischmann K E
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass, USA.
J Gen Intern Med. 1999 Jan;14(1):10-4. doi: 10.1046/j.1525-1497.1999.00274.x.
To determine the outcome, safety, and possible cost savings of patients undergoing weekend or holiday exercise treadmill testing.
Medical records of all 195 patients scheduled for weekend and holiday exercise testing were reviewed, and 77.9% of patients were contacted by telephone to ascertain medical outcomes and need for further emergency department or inpatient care. Costs were calculated from estimates of days of hospitalization saved and incremental costs incurred in conjunction with weekend or holiday testing.
Urban tertiary care academic medical center.
A total of 195 patients were scheduled for testing, and 181 tests were performed. Over three quarters (75.1%) of patients underwent testing for assessment of chest pain. Other indications included risk stratification after myocardial infarction or coronary angioplasty or prior to noncardiac surgery, or evaluation for arrhythmias, dyspnea, or syncope.
Outcomes included results and complications of testing, hospital course after testing, subsequent emergency department visits and readmissions, myocardial infarction, need for cardiac catheterization or revascularization, and mortality. No complications were noted during testing. In 136 patients tested for the indication of chest pain, 90 (66.2%) had negative tests, 39 (28. 7%) were intermediate, and 6 (4.4%) were positive for ischemia. Same day discharge occurred in 115 (84.6%) of the patients, saving an estimated 185 days of hospitalization ($316.83 per patient tested). Event rates over the 6 months following discharge were low.
Weekend and holiday exercise testing is a safe and effective means of risk stratification prior to hospital discharge for patients with chest pain. It also reduces length of stay and is cost saving.
确定在周末或节假日接受运动平板试验的患者的结果、安全性及可能的成本节约情况。
回顾了所有195例计划在周末和节假日进行运动试验的患者的病历，并通过电话联系了77.9%的患者，以确定医疗结果以及是否需要进一步的急诊科或住院治疗。成本是根据节省的住院天数估计值以及与周末或节假日检测相关的增量成本计算得出的。
城市三级医疗学术医学中心。
共有195例患者计划进行检测，共进行了181次检测。超过四分之三（75.1%）的患者接受检测以评估胸痛。其他指征包括心肌梗死或冠状动脉血管成形术后或非心脏手术前的风险分层，或心律失常、呼吸困难或晕厥的评估。
结果包括检测结果和并发症、检测后的住院过程、随后的急诊科就诊和再入院情况、心肌梗死、心脏导管插入术或血运重建的需求以及死亡率。检测期间未发现并发症。在136例因胸痛指征接受检测的患者中，90例（66.2%）检测结果为阴性，39例（28.7%）为中间结果，6例（4.4%）为缺血阳性。115例（84.6%）患者在当天出院，估计节省了185个住院日（每位接受检测的患者节省316.83美元）。出院后6个月内的事件发生率较低。
周末和节假日运动试验是胸痛患者出院前进行风险分层的一种安全有效的方法。它还能缩短住院时间并节省成本。
