Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Department of Medicine and Community Care, Royal Melbourne Hospital, Melbourne, VIC, Australia.
Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.
Ultrasound Med Biol. 2022 Feb;48(2):170-179. doi: 10.1016/j.ultrasmedbio.2021.09.013. Epub 2021 Nov 2.
The aim in this systematic review was to determine the effect of point-of-care ultrasound (POCUS) on the clinical decision-making process and patient outcomes in adults admitted to the general medicine ward. A comprehensive search was performed in MEDLINE (Ovid), EMBASE (Ovid), PubMed, the Cochrane Library, ClinicalTrials.gov, Scopus, LILACS and Cinahl. Articles had to fulfill the inclusion criteria of randomised or non-randomised studies assessing the impact of POCUS on the diagnosis, management, length of hospital stay or mortality of patients admitted to the internal medicine ward. Six studies were included involving a total of 1836 patients. The influence of POCUS on the diagnosis was reported as a change in the main diagnosis or the addition of a relevant diagnosis in up to 18% and 24% of the cases, respectively. Impact on the management plan was reported in 37% to 52.1% of the participants. Three studies documented the impact of POCUS on the length of stay. Two of them reported no difference between groups, and the other reported a significant reduction of 1 d of the hospital stay. In conclusion, POCUS appears to have positive effects on the clinical decision-making process with impacts on optimal patient management and possible reduction in the hospital length of stay.
本系统评价的目的是确定即时护理超声（POCUS）对成人普通内科病房入院患者的临床决策过程和患者结局的影响。在 MEDLINE（Ovid）、EMBASE（Ovid）、PubMed、Cochrane 图书馆、ClinicalTrials.gov、Scopus、LILACS 和 Cinahl 中进行了全面检索。文章必须符合纳入标准，即评估 POCUS 对内科病房入院患者的诊断、管理、住院时间或死亡率影响的随机或非随机研究。共纳入了 6 项研究，涉及 1836 名患者。POCUS 对诊断的影响表现为主要诊断的改变或相关诊断的添加，分别占病例的 18%和 24%。37%至 52.1%的参与者报告了对管理计划的影响。有 3 项研究记录了 POCUS 对住院时间的影响。其中 2 项研究报告组间无差异，另一项研究报告住院时间缩短 1 天。总之，POCUS 似乎对临床决策过程产生了积极影响，对患者的最佳管理产生了影响，并可能缩短了住院时间。
