在接受先天性心脏手术的患者中,手术前的胸外心声图的全面性和诊断错误
Chau P Nguyen1,2, Sanghee S Ro3,4, Andrew Jergel5
1Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA. nguyen.chauphanbao@gmail.com.
Pediatric cardiology
|May 20, 2025
概括
对心声回声图的新综合性评分 (CS) 并没有显著减少儿科先天性心脏手术的诊断错误. 认知因素,而不是全面性,是错误的主要原因,这表明质量改进应该针对这些认知方面.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 提高质量 提高质量
背景情况:
- 美国心脏病学院开发了一种超胸腔心声扫描 (TTE) 检查的质量指标.
- 评估TTE的全面性对于先天性心脏手术中的患者安全至关重要.
研究的目的:
- 评估TTE综合性得分 (CS) 与患有先天性心脏手术的儿科患者的诊断错误之间的关系.
- 确定心声回声学诊断错误的主要原因.
主要方法:
- 从2018年至2023年间,对2448次手术前TTEs进行了回顾性审查.
- 与没有错误的对照对照的TTEs与诊断错误的比较.
- 盲目审稿人分配一个CS,并描述错误类型和贡献者.
主要成果:
- 在有诊断错误和没有诊断错误的TTEs之间,CS没有显著差异 (95.4%与93.1%,p=0.06).
- CS与错误贡献者有显著的相关性 (p=0.004).
- 认知因素 (51.6%) 是导致错误的最常见因素,特别是高CS (> 90%).
结论:
- TTE综合性得分没有有效地歧视诊断错误.
- 认知因素是先天性心脏手术时心声学诊断错误的主要驱动因素.
- 未来的质量改进举措应侧重于解决认知错误,以提高诊断准确度.
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