TY - JOUR
T1 - Routine Serum Enzyme Tests in the Diagnosis of Acute Myocardial Infarction
T2 - Cost-Effectiveness
AU - Fisher, Michael L.
AU - Kelemen, Michael H.
AU - Collins, David
AU - Morris, Frank
AU - Moran, George W.
AU - Carliner, Nathan H.
AU - Plotnick, Gary D.
PY - 1983/8
Y1 - 1983/8
N2 - To determine the cost-effectiveness of routine use of serial SGOT, lactic dehydrogenase (LDH), and LDH isoenzyme determinations in patients with suspected acute myocardial infarction (AMI), 166 consecutive patients admitted to a coronary care unit were prospectively identified and clinical findings analyzed independently using predetermined criteria. Based on chest pain characteristics, ECG, and creatine kinase—MB (CK-MB) results, patients were placed in categories of definite AMI (31%), possible AMI (34%), or AMI excluded (36%). The SGOT and/or LDH patterns were considered positive (ie, suggestive of AMI) in 82% of the patients with definite AMI but only confirmed CK-MB results. Positive SGOT/LDH results yielded new clinically relevant information in only 14 patients (8%). Total charges for SGOT/LDH determinations in these 166 patients totaled $10,938 or approximately $780 for each additional clinically important positive result. When serial ECG and CK-MB results are available, routine serial SGOT/LDH determinations are not justified.
AB - To determine the cost-effectiveness of routine use of serial SGOT, lactic dehydrogenase (LDH), and LDH isoenzyme determinations in patients with suspected acute myocardial infarction (AMI), 166 consecutive patients admitted to a coronary care unit were prospectively identified and clinical findings analyzed independently using predetermined criteria. Based on chest pain characteristics, ECG, and creatine kinase—MB (CK-MB) results, patients were placed in categories of definite AMI (31%), possible AMI (34%), or AMI excluded (36%). The SGOT and/or LDH patterns were considered positive (ie, suggestive of AMI) in 82% of the patients with definite AMI but only confirmed CK-MB results. Positive SGOT/LDH results yielded new clinically relevant information in only 14 patients (8%). Total charges for SGOT/LDH determinations in these 166 patients totaled $10,938 or approximately $780 for each additional clinically important positive result. When serial ECG and CK-MB results are available, routine serial SGOT/LDH determinations are not justified.
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U2 - 10.1001/archinte.1983.00350080047012
DO - 10.1001/archinte.1983.00350080047012
M3 - Article
C2 - 6409023
AN - SCOPUS:84948725587
SN - 0003-9926
VL - 143
SP - 1541
EP - 1543
JO - Archives of internal medicine
JF - Archives of internal medicine
IS - 8
ER -