Mobile cardiac catheterization: comparison with outpatient and inpatient catheterization at tertiary facilities.
The study group included 1,553 consecutive patients from areas serviced by our mobile catheterization laboratories: 719 procedures were performed in the mobile unit at their local hospitals, 277 were performed at a tertiary hospital with less than a 24 hr hospital stay, and 557 were performed at a tertiary hospital as inpatients. The indications for mobile catheterization were predominantly atypical chest pain, angina pectoris, or positive treadmill stress test, whereas patients with less than 24 hr hospitalization at the tertiary center had their catheterization performed for additional reasons. The majority of the inpatient indications were for recent myocardial infarction or unstable angina. Using the American College of Cardiology/American Heart Association (ACC/AHA) criteria for outpatient catheterization, the mobile catheterizations were performed safely with a complication rate of only 0.7% compared to a complication rate of 3.1% for inpatients demonstrating that a low risk group of patients can be prospectively identified and catheterized safely in the mobile setting. An extremely high risk group of patients with ongoing unstable angina and recent myocardial infarction was also identified which should undergo catheterization only at a tertiary center.
Elliott
C M
CM
Mobile Cardiac Catheterization Laboratory, Sanger Clinic, Charlotte, NC 28203.
Bersin
R M
RM
Elliott
A V
AV
Fedor
J M
JM
Gallagher
J J
JJ
Sellers
L J
LJ
Simonton
C A
CA
Svenson
R H
RH
Wilson
B H
BH
Zimmern
S H
SH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D007755:Laboratories, Hospital / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units / Q000458:organization & administration*; D009657:North Carolina; D015397:Program Evaluation