Clinical guidance of patients after making an ECG in Family Medicine

• Type: International Conference Proceedings Book
• Date: 2010

Authors

Paulo Santos (Author) FMUP

Publisher

16th WONCA EUROPE CONFERENCE

Malaga, Spain

Conference International

16th WONCA EUROPE CONFERENCE

Malaga, Spain, 6 a 9 de Outubro de 2010

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

CORDIS: Health sciences > Medical sciences > Medicine > Family medicine

Other information

Abstract (EN): Introduction: Electrocardiogram (ECG) is an important test at practice of Family Medicine where it is requested very often. Purpose: The aim of this study is to characterize the clinical guidance of patients after making an ECG, asked by their Family Medicine Physician. Methods: A crossectional study of a consecutive sample of ECG was made. Data were collected during 24 months, starting in 01/03/2007, at office visits of 9 Family Medicine Physicians of an urban Health Center, Centro de Saúde de S. João, Oporto, Portugal, by filling a structured grid. A copy of exam was attached to description and codification by NOVACODE by physicians with experience. Six months later, clinical records were hand searched in order to establish clinical guidance of patients. We used confidence intervals of 95% and a multinominal logistic model to test null hypothesis. Results: 870 tests were analysed corresponding to 817 patients (56,4% females) with median age of 58 years (interquartil range – 42-71 years). The main motives for asking to an ECG were follow-up of patients with cardiovascular risk factors (25,1%), global health examination (22,6%), chest pain (18,4%) and palpitations (11,8%). 54,5% of ECG were normal and 9,7% presented major abnormalities. 6 months later , in 67,9% of patients there was no alteration from baseline, in 12,3% there was a prescription of another complementary test and 5,7% were refered to hospital care. In multivariate analysis, factors that influenced the orientation were abnormalitites presented in ECG (p<0,001), doctor that asked to ECG (p<0,001), reason for asking to ECG (p<0,001), time (days) to make ECG after request (p=0,001), presence of arterial hypertension (p=0,003) and type 2 diabetes mellitus (p=0,003). Conclusions: At practice of Family Medicine, ECG is commonly requested for study of complaints assigned to heart. In most patients there isn’t any alteration from baseline care. This leads to a final question to be answered: is ECG useless or is there another value still unstudied.

Language: English

Type (Professor's evaluation): Scientific