Assessing the Inter-observer Agreement of Electrocardiography Interpretation in the Elderly Surgical Patients: A Cross-Sectional Study
DOI:
https://doi.org/10.36408/mhjcm.v10i3.969Keywords:
Electrocardiography, elective surgery procedure, elderlyAbstract
Background: Electrocardiography (ECG) is an essential objective diagnosis tool, specifically for the elderly who are about to undergo surgery. From the examination results, it is possible to determine the presence of a heart condition that could impair the surgical outcome. Furthermore, the examination is slightly influenced by the subjectivity of observers.
Purpose: To evaluate the inter-observer agreement on the reader of a 12-lead ECG on elderly patients subjected to elective surgery.
Method: A consequential ECG examination was conducted on elderly patients who underwent elective surgery at Dr. Kariadi Hospital Semarang between July and November 2021. Two junior internist observers were independently involved in reading the ECG results in different places. The inter-observer reliability analysis used kappa statistics to determine consistency between observers.
Result: Analysis was carried out on 193 patients aged 60-87 years old, with a prevalence of abnormal ECG was 33.7%. Kappa Conformity Value was 0.864 (95 % CI: 0.790-0.938, p<0.001).
Conclusion: The value of agreement between junior internists in ECG interpretation among elderly surgical patients is good (kappa value >0.8). Even though the observers are junior internist, the result of the interpretation with a high kappa is considered to have reliable validity.
Downloads
References
1. Simova I, Bortolan G, Christov I. ECG attenuation phenomenon with advancing age. J Electrocardiol, 2018;51(6):1029–34.
2. Vicent L, Martínez-Sellés M. Electrocardiogeriatrics: ECG in advanced age. J Electrocardiol. 2017;50(5):698–700.
3. Stephanie Choo CC. Easy Peasy ECG. In: Vaswani A, Khaw HJ, Dougherty SD, Zamvar V, Lang CC, editors. Cardiology in a heartbeat. United Kingdom: Scion Publishing Limited; 2016: 43–54.
4. Schneiter S, Trachsel LD, Perrin T, Albrecht S, Pirrello T, Eser P, et al. Inter-observer agreement in athletes ECG interpretation using the recent international recommendations for ECG interpretation in athletes among observers with different levels of expertise. PLoS One. 2018;13(11):1–12.
5. Terho HK, Tikkanen JT, Junttila JM, Anttonen O, Kentta TV, Aro AL, et.al. Prevalence and Prognostic Significance of Fragmented QRS complewx in Middle-Aged Subjects With and Without Clinical or Electrocardiographic Evidence of Cardiac Disease. Am J Cardiol. 2014;114:141–7.
6. Yeh SSF, Chen CYJ, Wu IC, Hsu CC, Chen TY, Tseng WT, et al. Prognostic value and prevalence of complete right bundle branch block in an elderly population: a community-based 10-year prospective study. Aging. 2020;12(19):19073–82.
7. BPS BPPN. Proyeksi Penduduk Indonesia 2010-2035.
8. Al-Taki M, Sukkarieh HG, Hoballah JJ, Jamali SF, Habbal M, Masrouha KZ, et al. Effect of gender on postoperative morbidity and mortality outcomes: A retrospective cohort study. American Surgeon. 2018;84(3):377–86.
9. IES. Indonesian Culture. The Cultural Atlas [Internet]. 2021;ث ققثق(ثق ثقثقثق):1. Available from: https://culturalatlas.sbs.com.au/reference
10. Benetos A, Petrovic M, Strandberg T. Hypertension Management in Older and Frail Older Patients. Circ Res. 2019;124(7):1045–60.
11. Macfarlane PW. The influence of age and sex on the Electrocardiogram. Adv Exp Med Biol. 2018;1065(1):93–106.
12. Harkness WT, Hicks M. Right Bundle Brand Block. In: Aboubakr S, Abu-Ghosh A, Sedeh PA, Aeby TC, Aeddula NR, editors. Statpearls. StatPearls Publising; 2023.
13. Baltazar RF. Intraventricular conduction defect:bundle branch block. In: Destifano F, McMillan L, Martz B, editors. Basic and bedside electrocardiography. 1st ed. Philadelphia: Wliter Kluwer; 2009:127.
14. Bjarnason-Wehrens B. Elderly patients with ischaemic heart disease need our attention! Eur J Prev Cardiol. 2018;25(3):276–7.
15. Ochiai ME, Lopes NH, Buzo CG, Pierri H. Manifestação Atípica da Isquemia Miocárdica no Idoso. Arq Bras Cardiol. 2014;102(3):2013–5.
16. Olesen LL, Andersen A. ECG as a first step in the detection of left ventricular systolic dysfunction in the elderly. ESC Heart Fail. 2016;3(1):44–52.
Additional Files
Published
How to Cite
Issue
Section
Citation Check
License
Copyright (c) 2023 Yudo Murti Mupangati, Henry Setyawan, Czeresna Heriawan Soejono, Muhammad Hussein Gasem, Ignatius Riwanto
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyrights Notice
Copyrights:
Researchers publishing manuscrips at Medica Hospitalis: Journal of Clinical Medicine agree with regulations as follow:
Copyrights of each article belong to researchers, and it is likewise the patent rights
Researchers admit that Medica Hospitalia: Journal of Clinical Medicine has the right of first publication
Researchers may submit manuscripts separately, manage non exclusive distribution of published manuscripts into other versions (such as: being sent to researchers’ institutional repository, publication in the books, etc), admitting that manuscripts have been firstly published at Medica Hospitalia: Journal of Clinical Medicine
License:
Medica Hospitalia: Journal of Clinical Medicine is disseminated based on provisions of Creative Common Attribution-Share Alike 4.0 Internasional It allows individuals to duplicate and disseminate manuscripts in any formats, to alter, compose and make derivatives of manuscripts for any purpose. You are not allowed to use manuscripts for commercial purposes. You should properly acknowledge, reference links, and state that alterations have been made. You can do so in proper ways, but it does not hint that the licensors support you or your usage.
