Agreement between Emergency Physicians and a Cardiologist on Cardiac Function Evaluation after Short Training

  • Apichaya Monsomboon Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Thiti Patarateeranon Emergency Medicine Unit, Taksin Hospital, Medical Service Department, Bangkok 10600
  • Surat Tongyoo Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Usapan Surabenjawong Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Wansiri Chaisirin Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Tipa Chakorn Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Nattakarn Praphruetkit Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Onlak Ruangsomboon Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Tanyaporn Nakornchai Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Keywords: Cardiac function evaluation; limited echocardiography; volume assessment

Abstract

Objective: Delayed diagnosis and treatment of shock patients may lead to multiorgan dysfunction syndrome and death. Volume status assessment in shock patients is crucial for guiding early management. Focused echocardiography has become an important tool for assessing volume status because it is non-invasive and easy to perform. We aimed to ascertain the degree of agreement between emergency medicine (EM) residents and a cardiologist on cardiac function evaluations using echocardiography. We also assessed the extent of agreement on pericardial effusion diagnoses.
Methods: A cross sectional study was conducted at the Emergency Department, Siriraj Hospital. The EM residents who had limited experience in ultrasound examination underwent a 3-hour echocardiography training course consisting of a lecture and a workshop before starting the study. Patients with shock or suspected hypervolemia
were included. Echocardiography was performed by EM residents to evaluate ventricular function of each patients. With visual estimation, they classified the left ventricular function (LVF) into 3 categories: good, moderate and poor. The video files were recorded and re-evaluated by a cardiologist offline. The correlation of left ventricular function estimation and the diagnosis of pericardial effusion between the two operators were determined.
Results: Ninety-two patients were enrolled between October and December 2014. The overall agreement of ventricular function assessment between the EM residents and the cardiologist was 79.4% (weighted kappa = 0.73). The degree of agreements of LVF classified as poor, moderate and good LVF were 87.5%, 37.5% and 95% respectively. Moreover, the residents diagnosed the pericardial effusion with 100% accuracy, compared to the cardiologist.
Conclusion: Following a short educational training, the EM residents efficiently assessed the left ventricular function with a high level of agreement with a cardiologist.

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Published
2019-07-24
How to Cite
Monsomboon, A., Patarateeranon, T., Tongyoo, S., Surabenjawong, U., Chaisirin, W., Chakorn, T., Praphruetkit, N., Ruangsomboon, O., & Nakornchai, T. (2019). Agreement between Emergency Physicians and a Cardiologist on Cardiac Function Evaluation after Short Training. Siriraj Medical Journal, 71(4), 253-260. Retrieved from https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/205196
Section
Original Article