Knowledge Assessment on the Management of Acute Cor Pulmonale: An Interdisciplinary Survey Study
Levin Bolt1, Alain Rudiger2, Alexander Turk3
1Department of Internal Medicine, Stadtspital Zurich Triemli, 8063 Zurich, Switzerland.
Abstract:
Background/Objectives: Acute cor pulmonale is a critical clinical condition often encountered in acute care settings. Optimal management demands coordinated, interdisciplinary care. The aim of this study was to assess the current knowledge and management strategies for acute cor pulmonale among different groups of physicians involved in acute care in Switzerland. Methods: A structured questionnaire, extrapolated from the Acute Cardiovascular Care Association of the European Society of Cardiology clinical consensus statement on the diagnosis and treatment of cor pulmonale, was distributed among physicians of four specialties. Results: A total of 110 physicians participated in this multicenter survey, including 15 "experts," 71 "generalists" (internal and emergency medicine), and 24 "specialists" (cardiology and intensive care). Experts validated 29 out of 40 questionnaire items (Fleiss Kappa 0.63), which were then used for analysis. Overall, there was substantial agreement with the experts' answers among non-experts, with most correct response rates exceeding 60%. Significant differences were observed for only two items: experts more frequently recognized the prognostic value of clinical models (87% vs. 59%, p = 0.046) and the correct indications for systemic thrombolysis (100% vs. 76%, p = 0.037). Between generalists and specialists, differences in knowledge were minimal. Specialists more accurately identified the role of repeated arterial blood gas analysis, while generalists showed better awareness of clinical prognostic models. Conclusions: The study highlights a sound knowledge of acute cor pulmonale among acute care physicians, regardless of specialty. Despite comparable levels of knowledge, some variations reflect their clinical roles and information sources. The results emphasize the value of existing educational efforts and support the need for comprehensive, accessible guidelines to standardize care in complex conditions like acute cor pulmonale.
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