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[Suitability and performance of echocardiogram in primary care].

Abstract：

OBJECTIVE:The echocardiogram (ECC) is not available to all Spanish General Practitioners (GP) despite its proven benefits in prevalent diseases, such as hypertension and heart failure. STUDY OBJECTIVE:To analyse the clinical adequacy of the application, performance, and diagnostic and therapeutic decisions of ECC indicated by the GP. DESIGN:Descriptive, cross-sectional, retrospective, multicentre study. SETTING:Primary care. Four health centres (HC). PARTICIPANTS:A total of 684 patients over 18 years who had an ECC performed in 2006-2007. MAIN MEASUREMENTS:A review of medical records and the ECC report. The socio-demographic variables, clinical and diagnostic performance were also evaluated. RESULTS:The majority of patients (62.3%) were ≥ 65 years, of which 61.8% were female The most frequent reasons for performing ECC were (but not limited to): heart failure: 30%, suspected valvular disease: 26%; suspected cardiomyopathy: 24.3%. Adequacy of the ECC: 84% (95% CI: 81.09-86.7%) with differences by age (p=.02), HC teaching (p<.001), comorbidity (p<.001) and abnormal ECC (p<.001). A disease was found in 80% of ECC, with differences according to age (p<.001), comorbidity (p=0.02), cardiovascular risk factors (p<.001) and degree of appropriateness of ECC (p=.001). The most common findings (but not limited to) included: valvular heart disease (61.6%) left ventricular hypertrophy (43%) diastolic dysfunction (28.2%). The results of the ECC helped make decisions in 35.2%, with 17.1% referred to cardiology, 10.5% treatment change and 9.6% other tests. CONCLUSIONS:We found that the application of ECC was highly appropriate. The results of ECC drive clinical decisions in a high percentage of cases. The ECC should be accessible to all GP.

journal_name

Aten Primaria

journal_title

Atencion primaria

authors

de la Figuera M,Fernández J,Fernández MI,Castelló M,Canadell J,ARECO.

doi

10.1016/j.aprim.2011.03.007

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

190-8

issue

4

eissn

0212-6567

issn

1578-1275

pii

S0212-6567(11)00356-8

journal_volume

44

pub_type

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