Usefulness of Multi-Organ Point-of-Care Ultrasound as a Complement to the Decision-Making Process in Internal Medicine.
Irene Casado-LópezYashdeep Singh PathaniaMarta Torres-ArreseDavide Luordo-TedescoArantzazu Mata-MartínezJose Manuel Casas-RojoEsther Montero-HernándezGonzalo García De Casasola-SánchezPublished in: Journal of clinical medicine (2022)
Accumulated data show the utility of diagnostic multi-organ point-of-care ultrasound (PoCUS) in the assessment of patients admitted to an internal medicine ward. We assessed whether multi-organ PoCUS (lung, cardiac, and abdomen) provides relevant diagnostic and/or therapeutic information in patients admitted for any reason to an internal medicine ward. We conducted a prospective, observational, and single-center study, at a secondary hospital. Multi-organ PoCUS was performed during the first 24 h of admission. The sonographer had access to the patients' medical history, physical examination, and basic complementary tests performed in the Emergency Department (laboratory, X-ray, electrocardiogram). We considered a relevant ultrasound finding if it implied a significant diagnostic and/or therapeutic change. In the second semester of 2019, we enrolled 310 patients, 48.7% were male and the mean age was 70.5 years. Relevant ultrasound findings were detected in 86 patients (27.7%) and in 60 (19.3%) triggered a therapeutic change. These findings were associated with an older age (Mantel-Haenszel χ 2 = 25.6; p < 0.001) and higher degree of dependency (Mantel-Haenszel χ 2 = 5.7; p = 0.017). Multi-organ PoCUS provides relevant diagnostic information, complementing traditional physical examination, and facilitates therapy adjustment, regardless of the cause of admission. Multi-organ PoCUS to be useful need to be systematically integrated into the decision-making process in internal medicine.
Keyphrases
- emergency department
- end stage renal disease
- ejection fraction
- magnetic resonance imaging
- newly diagnosed
- decision making
- chronic kidney disease
- physical activity
- healthcare
- peritoneal dialysis
- prognostic factors
- computed tomography
- mesenchymal stem cells
- electronic health record
- social media
- bone marrow
- contrast enhanced ultrasound
- adverse drug
- acute care
- community dwelling
- health information
- drug induced
- replacement therapy