Evaluation of Cardiology Consultation Quality and Quantity Requested from Emergency Departments in Turkey

Abstract

Introduction: Emergency cardiac consultation is a very big part of cardiology practice and there is not any trial evaluating this subject qualitatively and quantitatively with different perspectives yet. We wanted to investigate this process in terms of correlation between emergency physicians and cardiologists. Methods: Patients who are consulted in a cross-sectional and prospectively 5 different public hospitals were included in the study. In order to examine the nature and intensity of the cardiology consultations and also the diagnostic compatibility, electrocardiography (ECG) and to investigate the adequacy of the first medical treatment were chi-square and correlation analyzes. A P value <0.05 was accepted as a statistical significance limit. Results: Totally 627 patients (502 patients by practitioners and 125 patients by emergency medicine specialists) were consulted to cardiology. The most common admission cause was chest pain (%47.8), and the most common cause of consultation was having no/weak idea about patient’s clinical diagnosis (%39.9). The diagnosis consistency of 48% of consulted patients by EMS was excellent while it was 32.1% in practitioners (p=0.001). Good and excellent ECG interpretation of EMS was 72.8% and it was 50.7% in practitioners (p<0.001). Good and excellent first medical treatment were 46.4% in EMS while it was 38,4 in practitioners (p=0.05). Nearly half of consultations (48.8%) were considered as definitely unnecessary or unnecessary by cardiologists. There was statistically significant correlation between the necessity of consultation and last decision (r=0.811, p<0.001). Conclusion: There is a big variability in emergency cardiac consultations from the standpoint of consultation necessity, ECG interpretation, first medical management quality and accurate diagnosis.