MI Lab and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway.
Eur J Intern Med. 2012 Mar;23(2):185-91. doi: 10.1016/j.ejim.2011.10.009. Epub 2011 Nov 9.
We aimed to investigate the potential benefit of adding a routine cardiac and abdominal diagnostic examination by pocket-sized ultrasound device in patients admitted to a medical department.
A random sample of 196 patients admitted to the medical department at a non-university hospital in Norway between March and September 2010 was studied. The patients underwent cardiac and abdominal screening with a pocket-sized ultrasound device with B-mode and color flow imaging after a principal diagnosis was set. Three internists/cardiologists experienced in ultrasonography performed the examinations. Diagnostic corrections were made and findings were confirmed by high-end echocardiography and examinations at the radiologic department.
196 patients were included (male=56.6%, mean±SD; 68.1±15.0 years old). The time spent doing the ultrasound screening was mean±SD 4.3±1.6 min for the cardiac screening and 2.5±1.1 min for the abdominal screening. In 36 (18.4%) patients this examination resulted in a major change in the primary diagnosis. In 38 (19.4%) patients the diagnosis was verified and in 18 (9.2%) patients an important additional diagnosis was made.
By adding a pocket-sized ultrasound examination of <10 min to usual care, we corrected the diagnosis in almost 1 of 5 patients admitted to a medical department, resulting in a completely different treatment strategy without delay in many of the patients. Routinely adding a cardiac and abdominal ultrasound screening has the potential to rearrange inpatients workflow and diagnosis.
我们旨在研究在医学部门住院的患者中,通过使用口袋大小的超声设备进行常规心脏和腹部诊断检查的潜在益处。
研究纳入了 2010 年 3 月至 9 月期间在挪威一家非大学医院内科住院的 196 名患者的随机样本。在确定主要诊断后,患者使用口袋大小的超声设备进行心脏和腹部筛查,该设备具有 B 模式和彩色血流成像。三名经验丰富的内科医生/心脏病专家进行了检查。诊断进行了校正,通过高端超声心动图和放射科检查对结果进行了确认。
共纳入 196 名患者(男性占 56.6%,平均±标准差;68.1±15.0 岁)。心脏筛查的平均超声筛查时间为 4.3±1.6 分钟,腹部筛查的平均时间为 2.5±1.1 分钟。在 36 名(18.4%)患者中,该检查导致主要诊断发生重大变化。在 38 名(19.4%)患者中,诊断得到证实,在 18 名(9.2%)患者中发现了重要的附加诊断。
通过在常规护理中增加不到 10 分钟的口袋大小的超声检查,我们纠正了近 1/5 内科住院患者的诊断,在许多患者中无需延迟即可改变完全不同的治疗策略。常规添加心脏和腹部超声筛查有可能重新安排住院患者的工作流程和诊断。