| Summary: | A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfillment of the requirements for the degree
of Master of Public Health.
Johannesburg, 2017 === Background
South Africa is grappling with a quadruple burden of disease, and cardiovascular diseases with other non-communicable diseases are on the increase. Echocardiography is an expensive but vital basic screening and diagnostic tool for cardiac patients. Appropriate use criteria (AUC) have been developed for echocardiography to assist with avoiding unnecessary echocardiograms.
Aim and Objectives of the study
The aim of the study was to determine the clinical appropriateness of referrals to the echocardiography clinic at Chris Hani Baragwanath Academic Hospital using AUC. The specific objectives were:
1. Describe the socio-demographic profile of patients referred for echocardiography
2. Determine the clinical appropriateness of echocardiography referrals
3. Describe the clinical profile of patients referred for echocardiography
4. Determine whether socio-demographic and clinical profile influence the appropriateness of echocardiography referral
Methods
During July 2015, a cross-sectional study was conducted among all new patients referred to the echocardiography clinic at the Chris Hani Baragwanath Academic Hospital (CHBAH). Following informed consent, patient demographic information was collected. Clinical and echocardiography reports were obtained for all new patients and analyzed, using the 2011 AUC criteria for echocardiography.
The data were analysed using Minitab version 16.
Results
The majority of the study participants (n=270) were black African (88.3%); they had a mean age of 53 years (SD ±16.6) and 63.1% were female. The study found that 93.3% of new patients were appropriately referred, 3.7% (n=10) were inappropriately referred and 3.0% (n=8) had uncertain indications for echocardiography. Hypertension 45.5% (n=123/270) was the most common
clinical diagnosis on echocardiogram request, with the post-echocardiogram evaluation confirming that 41.6% (111/267) of all the patients had hypertensive heart disease. An HIV positive status was documented in only 10.6% (n=29) of the patients.
Conclusion
The AUC is a useful tool and yielded similar results at the CHBAH. There is a high burden of hypertensive heart disease in this population, which requires specific prevention strategies. === MT2017
|
|---|
