Casado-López Irene, Tung-Chen Yale, Torres-Arrese Marta, Luordo-Tedesco Davide, Mata-Martínez Arantzazu, Casas-Rojo Jose Manuel, Montero-Hernández Esther, García De Casasola-Sánchez Gonzalo
Department of Internal Medicine, Hospital Infanta Cristina, Parla, 28981 Madrid, Spain.
Department of Internal Medicine, Hospital Universitario La Paz, 28046 Madrid, Spain.
J Clin Med. 2022 Apr 18;11(8):2256. doi: 10.3390/jcm11082256.
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 χ2 = 25.6; p < 0.001) and higher degree of dependency (Mantel−Haenszel χ2 = 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.
累积数据表明，诊断性多器官床旁超声（PoCUS）在评估内科病房收治患者方面具有实用性。我们评估了多器官PoCUS（肺部、心脏和腹部）是否能为因任何原因入住内科病房的患者提供相关的诊断和/或治疗信息。我们在一家二级医院进行了一项前瞻性、观察性单中心研究。在入院后的头24小时内进行多器官PoCUS检查。超声检查人员可以获取患者的病史、体格检查以及在急诊科进行的基本辅助检查结果（实验室检查、X光、心电图）。如果超声检查结果暗示有重大的诊断和/或治疗改变，我们则认为该结果具有相关性。在2019年下半年，我们纳入了310例患者，其中48.7%为男性，平均年龄为70.5岁。在86例患者（27.7%）中检测到了相关的超声检查结果，其中60例（19.3%）引发了治疗方案的改变。这些结果与患者年龄较大（Mantel-Haenszel卡方检验χ2 = 25.6；p < 0.001）和较高的依赖程度（Mantel-Haenszel卡方检验χ2 = 5.7；p = 0.017）相关。多器官PoCUS可提供相关的诊断信息，补充传统体格检查，并有助于调整治疗方案，无论患者的入院原因是什么。多器官PoCUS若要发挥作用，需要系统地纳入内科的决策过程。
