对Syncope Workup诊断价值的评估:一个回顾性研究
Ashan T Hatharasinghe1, Kayvon Etebar2, Ryan Wolsky3
1Inpatient Consultants of North Carolina, Monroe, NC.
HCA healthcare journal of medicine
|July 10, 2023
概括
许多昏迷患者接受昂贵的诊断测试,但阳性率低. 根据诊断价值评估这些测试的必要性至关重要,以避免大量的医疗保健浪费.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 昏迷诊断通常涉及广泛和昂贵的测试.
- 目前的指导方针建议对昏迷处理采取更保守的方法.
- 在诊断失眠的测试上花费了大量的财务资源.
研究的目的:
- 评估在昏迷患者中使用的各种测试的诊断价值和阳性率.
- 评估昏迷的诊断方式的成本效益.
主要方法:
- 在8个医疗机构对10,036名成年昏迷患者进行了回顾性研究.
- 对心电图,CT脑,MRI脑,心电图,心脏应力测试,倾斜表测试和带超声波的阳性率的分析.
- 基于国家医疗保险平均值的成本估计.
主要成果:
- 只有9%的患者有积极的测试结果.
- 电心电图 (EKG) 的阳性率最高 (5.7%),其次是动脉超声波 (4.84%).
- 据估计,美国每年对昏迷治疗的浪费可能达到330亿美元.
结论:
- 尽管有指导方针,高成本,低收益的昏迷诊断测试仍然存在.
- 应仔细考虑每个测试的诊断效用,对于个别的昏迷患者.
- 重新评估目前的昏迷诊断方案是有必要的,以减少不必要的医疗保健支出.
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