声心成像用于诊断感染性内心炎的规范性适当性:一项为期11年的观察性研究
Antonella Cecchetto1,2, Giulia Baroni2, Angela Stievano2
1Cardiology Unit, University of Padua-Azienda Ospedaliera, Padua, Italy.
European heart journal. Cardiovascular Imaging
|November 3, 2025
概括
大多数疑似感染性内心炎 (IE) 的超声波请求是不适当的,即使在指导方针更新后. 改善对成像指南的遵守对于更好的患者护理和资源分配至关重要.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 传染性疾病 传染性疾病
背景情况:
- 胸外回声 (TTE) 和食道回声 (TEE) 对于诊断感染性内心炎 (IE) 是必不可少的.
- 对疑似IE的超声波 (美国) 请求正在增加,但缺乏2017年后适宜性长期数据.
研究的目的:
- 评估在住院患者中怀疑感染性内心炎 (IE) 的超声波 (US) 处方的适当性.
- 根据2017年适用使用标准 (AUC) 对膜心脏病多模式成像的适当性进行评估.
主要方法:
- 从2013年9月到2024年6月,对美国2,461份涉嫌IE的申请进行了回顾性审查.
- 使用2017年AUC,2015年ESCIE指南和2013年TEE指南进行适当性评估.
主要成果:
- 在11年中,63.4%的美国申请是不合适的 (1402个TTE,157个初始TEE).
- 在准则发布后,没有观察到适当性的显著变化 (p = 0.078).
- 心脏病专家提交的适当请求比非心脏病专家更多 (65.8%);IE在15.3%的适当请求中得到确认.
结论:
- 大多数美国对怀疑IE的请求是不合适的,特别是来自非心脏病学家.
- 需要更好地遵守目前对IE诊断的成像指南.
- 优化美国的利用率可以提高患者护理和资源管理.
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