Relation of Telemetry Use and Mortality Risk, Hospital Length of Stay, and Readmission Rates in Patients With Respiratory Illness

Nancy Dawson, M. Caroline Burton, Bryan Hull, Gregory Beliles, Ingrid Pritchard, Christopher Trautman, Laura Ferry, Amanda Doyon, Rebecca Colby, Andy Chuu, Shu Ting Kung, Tran Khang, Donna Durocher, Matthew Buras, Heidi Kosiorek, Neera Agrwal, Ayan Sen, Darin Goss, Holly Geyer

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalAmerican Journal of Cardiology
DOIs
StateAccepted/In press - 2017

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Patient Readmission
Telemetry
Length of Stay
Mortality
Respiratory Tract Infections
Confidence Intervals
Diagnosis-Related Groups
Expert Testimony
Hospitalization
Retrospective Studies
Guidelines

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Relation of Telemetry Use and Mortality Risk, Hospital Length of Stay, and Readmission Rates in Patients With Respiratory Illness. / Dawson, Nancy; Burton, M. Caroline; Hull, Bryan; Beliles, Gregory; Pritchard, Ingrid; Trautman, Christopher; Ferry, Laura; Doyon, Amanda; Colby, Rebecca; Chuu, Andy; Kung, Shu Ting; Khang, Tran; Durocher, Donna; Buras, Matthew; Kosiorek, Heidi; Agrwal, Neera; Sen, Ayan; Goss, Darin; Geyer, Holly.

In: American Journal of Cardiology, 2017.

Research output: Contribution to journalArticle

Dawson, N, Burton, MC, Hull, B, Beliles, G, Pritchard, I, Trautman, C, Ferry, L, Doyon, A, Colby, R, Chuu, A, Kung, ST, Khang, T, Durocher, D, Buras, M, Kosiorek, H, Agrwal, N, Sen, A, Goss, D & Geyer, H 2017, 'Relation of Telemetry Use and Mortality Risk, Hospital Length of Stay, and Readmission Rates in Patients With Respiratory Illness', American Journal of Cardiology. https://doi.org/10.1016/j.amjcard.2017.07.029
Dawson, Nancy ; Burton, M. Caroline ; Hull, Bryan ; Beliles, Gregory ; Pritchard, Ingrid ; Trautman, Christopher ; Ferry, Laura ; Doyon, Amanda ; Colby, Rebecca ; Chuu, Andy ; Kung, Shu Ting ; Khang, Tran ; Durocher, Donna ; Buras, Matthew ; Kosiorek, Heidi ; Agrwal, Neera ; Sen, Ayan ; Goss, Darin ; Geyer, Holly. / Relation of Telemetry Use and Mortality Risk, Hospital Length of Stay, and Readmission Rates in Patients With Respiratory Illness. In: American Journal of Cardiology. 2017.
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abstract = "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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AU - Burton, M. Caroline

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AU - Beliles, Gregory

AU - Pritchard, Ingrid

AU - Trautman, Christopher

AU - Ferry, Laura

AU - Doyon, Amanda

AU - Colby, Rebecca

AU - Chuu, Andy

AU - Kung, Shu Ting

AU - Khang, Tran

AU - Durocher, Donna

AU - Buras, Matthew

AU - Kosiorek, Heidi

AU - Agrwal, Neera

AU - Sen, Ayan

AU - Goss, Darin

AU - Geyer, Holly

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