Document Detail

Last-minute preoperative cardiology consultations: epidemiology and impact.
MedLine Citation:
PMID:  8579015     Owner:  NLM     Status:  MEDLINE    
To identify clinical predictors of last-minute preoperative cardiology consultations and to evaluate the impact of these consultations on patient care, we performed a retrospective case-control study including all 166 patients who received unscheduled cardiology consultations at the preadmission testing center (PATC) of an urban teaching hospital. Control subjects were 166 patients matched by date and category of surgical procedure. Significant (p < 0.05) independent predictors of last-minute consultations included history of myocardial infarction (odds ratio [OR] = 23.7; 95% confidence interval [CI] = 1.5 to 373), history of chest pain (OR = 15.3; 95% CI = 3.7 to 62.9), history of chronic obstructive lung disease (OR = 5.9; 95% CI = 1.1 to 32.9), prior echocardiography (OR = 3.4; 95% CI = 1.2 to 9.8), and age (OR per decade = 1.1; 95% CI = 1.04 to 1.1). Thus among patients undergoing elective noncardiac surgery, last-minute preoperative consultations are common and are usually precipitated by an abnormal electrocardiogram or history of cardiovascular disease. Last-minute consultations may be preventable if those patients with risk factors for consultation are identified in advance of the preadmission evaluation and referred for elective consultation.
J C Dudley; J A Brandenburg; L H Hartley; S Harris; T H Lee
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  131     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-03-11     Completed Date:  1996-03-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  245-9     Citation Subset:  AIM; IM    
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
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MeSH Terms
Boston / epidemiology
Cardiology / standards*
Case-Control Studies
Heart Diseases / epidemiology*
Hospitals, Teaching / statistics & numerical data
Hospitals, Urban / statistics & numerical data
Middle Aged
Patient Admission / statistics & numerical data
Preoperative Care
Referral and Consultation / standards,  utilization*
Risk Assessment
Risk Factors
Surgical Procedures, Operative / utilization*
Time Factors

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

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