[Survey on the timeliness and prognostic value of the decision to hospitalize in suspected acute myocardial infarct].
It was undertaken a survey, using 416 questionnaires returned from a sample of the Physicians on duty in the Emergency Department of Regione Piemonte (11 out of 25) over a period of 3 months and regarding patients coming to the observation for chest pain and suspected acute myocardial infarction/A.M.I., with the purpose of evaluating by univariate analysis the variable of decision-making subjects (General Practitioner, Physician On-Call, Cardiologist, Patient) behaviour and its effects on decision-making subject prevalence, hospitalization delay, positive predictive value/PPV for A.M.I. and final probability of hospitalization of A.M.I. within 3 hours. It was observed that 42% of the patients with suspected A.M.I. was referred by General Practitioner, 15% by Physician On-Call, 7% by a Cardiologist and 36% arrived by self-referral. The PPV for A.M.I. in the self-referred group was significantly lower in comparison with the PPV of the Cardiologist (p less than 0.01) and with the PPV of the Physician On-Call (p less than 0.01), but not in comparison with the PPV of the General Practitioner. Even if the timeliness of arrival in hospital was observed to be better in the self-referred group and in the group referred by the Physician On-Call, the final probability (considering subject intervention prevalence, PPV and timeliness) for the hospitalization of the A.M.I. within 3 hours from chest pain onset did not differ significantly among the groups of patients referred by the General Practitioner, the Physician On-Call, the Cardiologist or self-referred.
Pinna Pintor
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Fondazione Arturo Pinna Pintor, Torino.
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D002309:Cardiology; D003657:Decision Making; D004630:Emergencies; D006760:Hospitalization; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D010821:Physicians, Family; D011379:Prognosis; D011795:Surveys and Questionnaires; D013997:Time Factors
Inchiesta sulla tempestività e sul valore predittivo delle scelte di ricovero del sospetto infarto miocardico acuto.