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Assessment of priority for coronary revascularisation procedures. Revascularisation Panel and Consensus Methods Group.

https://arctichealth.org/en/permalink/ahliterature229092
Source
Lancet. 1990 May 5;335(8697):1070-3
Publication Type
Conference/Meeting Material
Article
Date
May-5-1990
Author
C D Naylor
R S Baigrie
B S Goldman
A. Basinski
Author Affiliation
Sunnybrook Health Science Centre, North York, Ontario, Canada.
Source
Lancet. 1990 May 5;335(8697):1070-3
Date
May-5-1990
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Adult
Aged
Angina Pectoris - radiography - therapy
Angina, Unstable - radiography - therapy
Coronary Disease - classification - radiography - surgery
Emergencies
Emergency Medical Services - standards
Evaluation Studies as Topic
Heart Function Tests
Humans
Models, Statistical
Myocardial Revascularization - methods
Observer Variation
Ontario
Questionnaires
Reference Standards
Regression Analysis
Risk factors
Severity of Illness Index
Time Factors
Triage - standards
Abstract
To develop guidelines for ranking the urgency with which patients with angiographically proven coronary disease need revascularisation procedures, factors that a panel of cardiac specialists agreed were likely to affect urgency were incorporated into 438 fictitious case-histories. Each panelist then rated the cases on a 7-point scale based on maximum acceptable waiting time for surgery; 1 on the scale represented emergency surgery and 7 delays of up to 6 months. For only 1% of cases was there agreement on a single rating by at least 12/16 panelists. Results of this ranking exercise were used by the panel to draw up triage guidelines. The three main urgency determinants were severity and stability of symptoms of angina, coronary anatomy from angiographic studies, and results of non-invasive tests for risk of ischaemia. Together these three factors generally gave an urgency rating for any given case to within less than 0.25 scale points of the value predicted with all factors. A numerical scoring system was derived to permit rapid estimation of the panel's recommended ratings.
Notes
Comment In: Lancet. 1990 Aug 4;336(8710):310-11973994
PubMed ID
1970377 View in PubMed
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