Weile Jesper, Laursen Christian B, Frederiksen Christian A, Graumann Ole, Sloth Erik, Kirkegaard Hans
Emergency Department, Regional Hospital Herning, Herning, Denmark.
Research Center for Emergency Medicine, Aarhus University Hospital, Palle Juul-Jensens Blvd. 161, 8200, Aarhus, Denmark.
BMC Emerg Med. 2018 Dec 27;18(1):60. doi: 10.1186/s12873-018-0211-4.
Point-of-care ultrasound (POCUS) can improve patient management in the emergency department (ED). However, previous studies have focused only on selected groups of patients, such as trauma, shock, dyspnea, or critically ill patients, or patients with an already known diagnosis. Most patients seen in the ED do not match these criteria. We aim to present total prevalence of positive findings when basic POCUS is applied to the broad population of patients seen in an emergency department.
We conducted a single-center prospective explorative observational study of 405 unselected patients aged 18 years or over. A structured whole-body ultrasound examination was performed on all patients within 2 h of arrival to the ED. The ultrasound examination consisted of focused cardiac ultrasound, focused abdominal ultrasound, focused assessment with sonography for trauma (FAST), and focused lung ultrasound.
We managed to perform 94.5% of all planned examinations. The study revealed positive findings in 39.3% of all included patients. This study presents the prevalence of positive findings among subgroups of patients. Divided among the categories of chief complaint, we found 62 positive examinations in 58 (14.3%; 95% CI, 10.9-17.7) unique patients with orthopedic complaints, 77 positive examinations among 59 (14.6%; 95% CI, 11.1-18.0) unique patients with medical complaints, and 55 positive examinations among 42 (10.4%; 95% CI, 7.4-13.3) unique patients with abdominal surgical complaints.
POCUS revealed positive findings in more than one third of unselected patients in the emergency department. The study presents the findings and distribution among categories of chief complaints. Future investigations are necessary to elucidate the implication of the findings.
床旁超声（POCUS）可改善急诊科（ED）的患者管理。然而，以往的研究仅聚焦于特定患者群体，如创伤、休克、呼吸困难或危重症患者，或已确诊的患者。急诊科中大多数患者并不符合这些标准。我们旨在呈现将基本POCUS应用于急诊科广大患者群体时阳性发现的总体患病率。
我们对405名18岁及以上未经过筛选的患者进行了单中心前瞻性探索性观察研究。在所有患者抵达急诊科后2小时内，对其进行了结构化的全身超声检查。超声检查包括心脏聚焦超声、腹部聚焦超声、创伤超声重点评估（FAST）和肺部聚焦超声。
我们成功完成了所有计划检查的94.5%。该研究显示，在所有纳入患者中，39.3%有阳性发现。本研究呈现了各亚组患者中阳性发现的患病率。按主诉类别划分，我们在58名（14.3%；95%可信区间，10.9 - 17.7）有骨科主诉的独特患者中发现62次阳性检查，在59名（14.6%；95%可信区间，11.1 - 18.0）有内科主诉的独特患者中发现77次阳性检查，在42名（10.4%；95%可信区间，7.4 - 13.3）有腹部外科主诉的独特患者中发现55次阳性检查。
POCUS在急诊科超过三分之一的未经过筛选的患者中发现了阳性结果。该研究呈现了阳性结果及其在主诉类别中的分布情况。有必要进行进一步研究以阐明这些发现的意义。
