The 2004 American Heart Association expert opinion-based guidelines restrict telemetry
use primarily to patients with current or high-risk cardiac conditions. Respiratory
infections have emerged as a common source of hospitalization, and telemetry is frequently
applied without indication in efforts to monitor patient decompensation. In this retrospective
study, we aimed to determine whether telemetry impacts mortality risk, length of stay
(LOS), or readmission rates in hospitalized patients with acute respiratory infection
not meeting American Heart Association criteria. A total of 765 respiratory infection
patient encounters with Diagnosis-Related Groups 193, 194, 195, 177, 178 and 179 admitted
in 2013 to 2015 to 2 tertiary community-based medical centers (Mayo Clinic, Arizona,
and Mayo Clinic, Florida) were evaluated, and outcomes between patients who underwent
or did not undergo telemetry were compared. Overall, the median LOS was longer in
patients who underwent telemetry (3.0 days vs 2.0 days, p <0.0001). No differences
between cohorts were noted in 30-day readmission rates (0.6% vs 1.3%, p = 0.32), patient
mortality while hospitalized (0.6% vs 1.3%, p = 0.44), mortality at 30 days (7.9%
vs 7.7%, p = 0.94), or mortality at 90 days (13.5% vs 13.5%, p = 0.99). Telemetry
predicted LOS for both univariate (estimate 1.18, 95% confidence interval 1.06 to
1.32, p = 0.003) and multivariate (estimate 1.17, 95% confidence interval 1.06 to
1.30, p = 0.003) analyses after controlling for severity of illness but did not predict
patient mortality. In conclusion, this study identified that patients with respiratory
infection who underwent telemetry without clear indications may face increased LOS
without reducing their readmission risk or improving the overall mortality.
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Article Info
Publication History
Published online: July 25, 2017
Accepted:
July 3,
2017
Received:
March 28,
2017
Footnotes
Grant Support: None.
See page 1420 for disclosure information.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
