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Is cardiology consultation required before cardiac catheterization?

Alan B. Jotkowitz1, Carlos Cafri, Jubran S. Dakwar

  • 1Departments of Medicine and Cardiology, Soroka University Medical Center, Beersheva, Israel; Faculty of Medicine, Ben-Gurion University of the Negev, Beersheva, Israel.

European Journal of Internal Medicine
|August 4, 2004
PubMed
Summary

Direct referral for cardiac catheterization by internists yields similar results to mandatory cardiology consultation. This approach is supported, though further research on hospitalist care is recommended.

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Area of Science:

  • Cardiology
  • Internal Medicine
  • Health Policy

Background:

  • Increasing trend of internist-led direct referrals for cardiac catheterization.
  • Shift away from mandatory cardiology consultations prior to cardiac procedures.

Purpose of the Study:

  • Compare outcomes of mandatory vs. optional cardiology consultation before cardiac catheterization.
  • Evaluate the impact of referral policies on patient management and diagnostic yield.

Main Methods:

  • Comparative study of 350 patients undergoing cardiac catheterization.
  • Two groups: mandatory cardiology consultation (closed) vs. optional consultation (open).
  • Primary outcomes: detection of significant coronary artery disease and subsequent therapy.

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Main Results:

  • No significant difference in coronary artery disease detection rates between groups (72% vs. 77%).
  • Similar rates of revascularization therapy in both groups (43% vs. 44%).
  • P-values indicate no statistical significance (P=NS) for outcome differences.

Conclusions:

  • Direct internist referral for cardiac catheterization is as effective as requiring cardiology consultation.
  • Supports policies enabling direct physician referrals for cardiac catheterization.
  • Further investigation needed for hospitalist management of cardiac patients without cardiology input.