Gupta Ankur, Kindarara Désiré M, Chun Kevin C, Datta Sandipan, Anderson Richard C, Irwin Zachary T, Newton Elise A, Lee Eugene S
Department of Research, 19981Sacramento Veterans Affairs Medical Center, Mather, CA, USA.
Patient Care Services, & Department of Research, Sacramento Veterans Affairs Medical Center, Mather, CA, USA; College of Health and Human Services/School of Nursing at California State University, Sacramento (CSUS), Sacramento, CA, USA.
Vasc Endovascular Surg. 2022 Apr 28:15385744221099093. doi: 10.1177/15385744221099093.
Point-of-care ultrasound (POCUS) has been reported as a valuable tool for bedside diagnoses of abdominal Aortic Aneurysms (AAA). However, no data exist regarding POCUS in measuring follow-up AAA diameter studies in patients with existing AAAs. The purpose of this study was to determine the variability of aortic measurements performed by a non-physician using POCUS vs standard of care (SOC) measurements by a registered vascular technologist or an abdominal/pelvic CT scan.
A prospective observational ultrasound study was performed from 1/1/2019 to 3/31/2021 on patients with a diagnosis of an AAA (≥3.0 cm). A research coordinator (non-physician) underwent a 3-hour training session in ultrasound operation and basic human anatomy to measure AAA diameter. The maximum aortic diameter was documented and compared to measurements obtained by SOC ultrasonography or CT scan. The POCUS and SOC ultrasounds were separated by no more than 90 days. Clinical risk factors including age, race, body mass index, coronary artery disease, hypertension, peripheral vascular disease, cerebrovascular disease, diabetes, and current smoking were also collected.
Eighty-one patients (mean age: 73.6 ± 5.8 years, body mass index: 29.5 ± 6.2 kg/m) were being followed in a vascular clinic and underwent both a POCUS and SOC ultrasounds. One indeterminant study was reported in identifying an AAA diagnosis, due to an overlying colostomy. The average follow-up time from initial screening aortic diameter to POCUS was 4.4 ± 3.7 years. Overall average aortic diameter measurements obtained were 4.1 ± .9 cm for POCUS and 4.0 ± .9 cm for SOC (P = NS). Average difference in aortic measurement for POCUS and SOC was -.1 ± .3 cm.
POCUS is an accurate method to follow AAA diameter in patients. POCUS could improve patient follow up with AAA diameter measurements, streamline care and reduce overall burden for both patients and Radiology Departments in assessing follow up AAA diameters.
床旁超声（POCUS）已被报道为腹主动脉瘤（AAA）床旁诊断的一种有价值的工具。然而，关于POCUS在测量现有AAA患者的随访AAA直径研究方面尚无数据。本研究的目的是确定由非医生使用POCUS进行的主动脉测量与由注册血管技术人员或腹部/盆腔CT扫描进行的标准护理（SOC）测量之间的差异。
2019年1月1日至2021年3月31日，对诊断为AAA（≥3.0厘米）的患者进行了一项前瞻性观察性超声研究。一名研究协调员（非医生）接受了为期3小时的超声操作和人体基本解剖学培训，以测量AAA直径。记录最大主动脉直径，并与通过SOC超声或CT扫描获得的测量值进行比较。POCUS和SOC超声之间的间隔不超过90天。还收集了包括年龄、种族、体重指数、冠状动脉疾病、高血压、外周血管疾病、脑血管疾病、糖尿病和当前吸烟情况等临床危险因素。
81名患者（平均年龄：73.6±5.8岁，体重指数：29.5±6.2千克/平方米）在血管诊所接受随访，并接受了POCUS和SOC超声检查。由于存在结肠造口术，在确定AAA诊断时报告了一项不确定研究。从初始筛查主动脉直径到POCUS的平均随访时间为4.4±3.7年。POCUS获得的总体平均主动脉直径测量值为4.1±0.9厘米，SOC为4.0±0.9厘米（P=无显著性差异）。POCUS和SOC主动脉测量的平均差异为-0.1±0.3厘米。
POCUS是随访患者AAA直径的一种准确方法。POCUS可以改善对患者AAA直径的随访，简化护理流程，并减轻患者和放射科在评估随访AAA直径方面的总体负担。
