Yield of Continuous Cardiac Monitoring in Pre-Specified Low-Risk Patients: A Retrospective Cohort Study

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia Pub Date : 2025-08-06 DOI:10.1111/1742-6723.70110

Danny Marhaba, Conor O'Flynn, Conor Jones, Jamie Formosa, Dion Stub, De Villiers Smit, Biswadev Mitra

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引用次数: 0

Abstract

Objectives

The aim of this study was to quantify the yield of continuous cardiac monitoring (CCM) in patients with pre-specified low-risk criteria, including those with mildly elevated troponin levels.

Methods

This was a retrospective cohort study of patients admitted to the ward from the emergency department (ED) with CCM. The primary outcome was the occurrence of clinically relevant arrhythmia. The secondary outcome was immediately life-threatening arrhythmia. Sub-group analyses were performed for patients presenting with chest pain, with initial mildly elevated and negative troponin levels.

Results

Of 1639 patients who were admitted to the ward from the ED with CCM, 403 met pre-specified low-risk criteria. Of those 403 patients, there were 16 (3.96%; 95% CI: 1.52%–6.38%) patients who had clinically relevant arrhythmia, and none had a critical arrhythmia. Among the subgroup of 84 patients presenting with chest pain who had a mildly elevated initial troponin, there was one clinically relevant arrhythmia (1.19%; 95% CI 0.00%–3.53%), and among the 174 patients presenting with chest pain and a negative troponin, there were five who had clinically relevant arrhythmia (2.94%; 95% CI: 0.44%–5.44%).

Conclusion

CCM in pre-specified low-risk patients admitted to the ward from the ED did not capture any immediately life-threatening arrhythmia. The observation of clinically relevant arrhythmia suggests that some relatively lower risk patients may benefit from CCM. Elucidation of this cohort can reduce the number of referrals for CCM and potentially improve patient flow within a hospital.

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预先指定的低风险患者持续心脏监测的产量：一项回顾性队列研究

本研究的目的是量化具有预先指定的低风险标准的患者的持续心脏监测（CCM）的产量，包括那些肌钙蛋白水平轻度升高的患者。方法：对急诊科（ED）收治的CCM患者进行回顾性队列研究。主要结局是临床相关心律失常的发生。次要结果是立即危及生命的心律失常。对出现胸痛、初始肌钙蛋白水平轻度升高和阴性的患者进行亚组分析。结果从急诊科入病房的1639例CCM患者中，403例符合预先规定的低风险标准。403例患者中，16例(3.96%；95% CI: 1.52%-6.38%)均有临床相关心律失常，无危重性心律失常。在84例初始肌钙蛋白轻度升高的胸痛患者亚组中，有1例临床相关心律失常(1.19%；95% CI 0.00%-3.53%)，在174例胸痛和肌钙蛋白阴性的患者中，有5例有临床相关的心律失常(2.94%；95% ci: 0.44%-5.44%)。结论对从急诊科入病房的预先指定的低危患者，CCM未发现任何立即危及生命的心律失常。对临床相关心律失常的观察表明，一些风险相对较低的患者可能受益于CCM。阐明这一队列可以减少CCM的转诊数量，并可能改善医院内的患者流量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Emergency Medicine Australasia 医学-急救医学

CiteScore

3.70

自引率

13.00%

发文量

217

审稿时长

6-12 weeks

期刊介绍： Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine. Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.