Document Detail


Assessment of priority for coronary revascularisation procedures. Revascularisation Panel and Consensus Methods Group.
MedLine Citation:
PMID:  1970377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To develop guidelines for ranking the urgency with which patients with angiographically proven coronary disease need revascularisation procedures, factors that a panel of cardiac specialists agreed were likely to affect urgency were incorporated into 438 fictitious case-histories. Each panelist then rated the cases on a 7-point scale based on maximum acceptable waiting time for surgery; 1 on the scale represented emergency surgery and 7 delays of up to 6 months. For only 1% of cases was there agreement on a single rating by at least 12/16 panelists. Results of this ranking exercise were used by the panel to draw up triage guidelines. The three main urgency determinants were severity and stability of symptoms of angina, coronary anatomy from angiographic studies, and results of non-invasive tests for risk of ischaemia. Together these three factors generally gave an urgency rating for any given case to within less than 0.25 scale points of the value predicted with all factors. A numerical scoring system was derived to permit rapid estimation of the panel's recommended ratings.
Authors:
C D Naylor; R S Baigrie; B S Goldman; A Basinski
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Publication Detail:
Type:  Consensus Development Conference; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Lancet     Volume:  335     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1990 May 
Date Detail:
Created Date:  1990-05-31     Completed Date:  1990-05-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1070-3     Citation Subset:  AIM; IM    
Affiliation:
Sunnybrook Health Science Centre, North York, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina Pectoris / radiography,  therapy
Angina, Unstable / radiography,  therapy
Coronary Disease / classification,  radiography,  surgery*
Emergencies
Emergency Medical Services / standards*
Evaluation Studies as Topic
Heart Function Tests*
Humans
Models, Statistical
Myocardial Revascularization / methods*
Observer Variation
Ontario
Questionnaires
Reference Standards
Regression Analysis
Risk Factors
Severity of Illness Index*
Time Factors
Triage / standards*
Comments/Corrections
Comment In:
Lancet. 1990 Aug 4;336(8710):310-1   [PMID:  1973994 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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