Validity of Computer-interpreted "Normal" and "Otherwise Normal" ECG in Emergency Department Triage Patients.

Introduction: Chest pain is the second most common chief complaint for patients undergoing evaluation in emergency departments (ED) in the United States. The American Heart Association recommends immediate physician interpretation of all electrocardiograms (ECG) performed for adults with chest pain...

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Publicado en:Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Vol. 25; no. 1; pp. 3 - 9
Autores principales: Deutsch, Ashley, Poroksy, Kye, Westafer, Lauren, Visintainer, Paul, Mader, Timothy
Formato: research tables/charts Journal Article
Publicado: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Jan2024
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Validity of Computer-interpreted "Normal" and "Otherwise Normal" ECG in Emergency Department Triage Patients.
      aug:
        au:
          Deutsch, Ashley
          Poroksy, Kye
          Westafer, Lauren
          Visintainer, Paul
          Mader, Timothy
        affil: University of Massachusetts Chan Medical School, Baystate Medical Center, Springfield, Massachusetts
      sug:
        subj:
          Validity
          Electrocardiography
          Emergency Patients
          Emergency Service
          Diagnosis, Computer Assisted
          ST Elevation Myocardial Infarction Diagnosis
          Chest Pain Diagnosis
          Myocardial Ischemia Diagnosis
          Human
          Female
          Male
          United States
          Prospective Studies
          Academic Medical Centers
          Electrocardiography Equipment and Supplies
          Triage
          Predictive Value of Tests
          Outcome Assessment
          Chi Square Test
          T-Tests
          Descriptive Statistics
          Female
          Male
      ab: Introduction: Chest pain is the second most common chief complaint for patients undergoing evaluation in emergency departments (ED) in the United States. The American Heart Association recommends immediate physician interpretation of all electrocardiograms (ECG) performed for adults with chest pain within 10 minutes to evaluate for the finding of ST-elevation myocardial infarction (STEMI). The ECG machines provide computerized interpretation of each ECG, potentially obviating the need for immediate physician analysis; however, the reliability of computer-interpreted findings of "normal" or "otherwise normal" ECG to rule out STEMI requiring immediate intervention in the ED is unknown. Methods: We performed a prospective cohort analysis of 2,275 ECGs performed in triage in the adultED of a single academic medical center, comparing the computerized interpretations of "normal" and "otherwise normal" ECGs to those of attending cardiologists. ECGs were obtained with a GE MAC 5500 machine and interpreted using Marquette 12SL. Results: In our study population, a triage ECGwith a computerized interpretation of "normal" or "otherwise normal" ECG had a negative predictive value of 100% for STEMI (one-sided, lower 97.5% confidence interval 99.6%). None of the studied patients with these ECG interpretations had a final diagnosis of STEMI, acute coronary syndrome, or other diagnosis requiring emergent cardiac catheterization. Conclusion: In our study population, ECG machine interpretations of "normal" or "otherwise normal" ECG excluded findings of STEMI. The ECGs with these computerized interpretations could safely wait for physician interpretation until the time of patient evaluation without delaying an acute STEMI diagnosis.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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