Echocardiography Impact Factor at Te Whatu Ora – Waitaha Canterbury

Abstract

To assess the impact of echocardiography on clinical management and outcomes among General Medicine inpatients at Christchurch Hospital. Over a 6-month period between 1 January and 30 June 2021, all General Medicine inpatients who underwent echocardiography were reviewed. Changes in clinical management following echocardiography were determined from clinical record review. A change in management was defined as a change in diagnosis, medical therapy, progression to further investigation, or referral to Cardiology or Cardiothoracic Surgery. A clinically important change was defined as takeover of care by Cardiology, referral for invasive cardiac investigation or intervention. Clinical outcome comprised major adverse cardiovascular events (MACE) at 12 months, defined as: all-cause mortality, readmission with myocardial infarction, heart failure hospitalisation, and stroke. Among 262 patients who underwent echocardiography, 206 patients (79%) received any change in clinical management. For 131 patients (50%), this led to a change to their discharge diagnosis. A clinically important management change occurred in 48 patients (18%), including 30 patients (12%) who were formally taken over by Cardiology during their admission. MACE occurred in 149 (57%), with 40 deaths recorded at 12-month follow-up (15%). Echocardiography is a valuable investigation for General Medical inpatients at Christchurch Hospital, with nearly one in five having findings that result in clinically important changes to acute management. The MACE rates reflect the comorbidity of the studied population.