quarta-feira, junho 09, 2010
A fina linha que divide a teimosia da falta de bom senso...
Stress echocardiography in the district hospital setting: a cost-saving analysis
Nicolai Wennike1, Benoy Nalin Shah2, Emma Boger2, Roxy Senior3 and Kim Greaves
European Journal of Echocardiography. Volume 11, Issue 5Pp. 401-405.
The cost saving of stress echocardiography, an accuracy analysis, and adverse outcomes at 6 and 24 months follow-up were determined. The total cost attributable to the stress echocardiography service was £58 368. If unavailable, 78 (39%) patients would have been referred for angiography and 122 (61%) for perfusion scintigraphy at a cost of £56 316 and £42 090, respectively, with a total cost of £98 406. This represents a cost saving of £40 038.
Conclusion Stress echocardiography is a cost saving method for the investigation of chest pain in patients with low–intermediate risk of flow limiting coronary artery disease in the district hospital setting.
In the case of exercise stress echocardiography, BRUCE protocol symptom-limited treadmill exercise testing was performed with images acquired immediately (within 90 s) after peak exercise. Early post-exercise images with the best endocardial definition were displayed alongside the corresponding baseline images. In patients in whom exercise testing was deemed not possible, dobutamine was infused peripherally in 3 min dose increments, starting from 10 µg/kg/min and increased to 20, 30, and 40 µg/kg/min.
Estudo mostra que o Ecostress é uma ferramenta eficiente e viável, na análise da dor torácica.
Sempre que possível, com o esforço.
É barato, rápido e seguro. Mas isso não basta para convencer certos serviços de cardiologia que insistem no ecostress farmacológico ou na cintilografia...