Hung Sheng-Yao, Huang Fen-Wei, Lien Wan-Ching, Chiu Te-Fa, Wong Tse-Chyuan, Lin Wei-Jun, Wu Shih-Hao
Department of Emergency Medicine, China Medical University Hospital, Taichung 404327, Taiwan.
School of Medicine, College of Medicine, China Medical University, Taichung 404328, Taiwan.
Diagnostics (Basel). 2025 Jun 21;15(13):1580. doi: 10.3390/diagnostics15131580.
Although the value of point-of-care ultrasound (PoCUS) is well-established for specific diseases and in the hands of trained users, its broader impact on overall ED efficiency is not yet fully known. This study aims to evaluate the association of early PoCUS, performed within 1 h of presentation, with ED patient flow, healthcare resource utilization, and quality of care in adults with non-traumatic abdominal pain. This retrospective cohort study included 44,863 adult patients (≥18 years) presenting with non-traumatic abdominal pain from January 2021 to December 2023. Patients were grouped into PoCUS and no-PoCUS categories, with a subgroup analysis for those receiving PoCUS within 1 h, to evaluate ED LOS, and costs for different ED dispositions. Outcomes measured included hospital LOS, costs, mortality, and ICU admission. The mean age of the subjects was 44.4 ± 17.9 years, and 61.2% were female. PoCUS was performed in 39.7% of cases, with 69.6% of these conducted within one hour. Additionally, 30.5% underwent CT. The PoCUS group had a significantly shorter ED LOS compared to the no-PoCUS group among patients admitted to general wards ( < 0.001), but not in outpatient dispositions ( = 0.282) or ICU admissions ( = 0.081). Subgroup analysis of patients receiving PoCUS within 1 h showed a significantly shorter LOS for both outpatient dispositions ( < 0.001) and general ward admissions ( < 0.001), with no effect on ICU admissions ( = 0.869). The presence or absence of CT did not alter these findings. Multivariable analysis indicated that patients who received PoCUS within one hour alone at index visit and admitted after an unscheduled return visit had lower initial ED costs (-9436.1 TWD, < 0.001) and shorter ED LOS (-11.59 min, < 0.001) than patients admitted directly at the index visit, with no significant increase in total resource utilization or adverse outcomes after return visits. PoCUS, especially when performed within one hour, was associated with reduced ED LOS and healthcare resource utilization for both outpatient dispositions and inpatient admissions without compromising patient safety or quality of care.
尽管即时超声检查(PoCUS)在特定疾病诊断以及由训练有素的操作人员使用时的价值已得到充分证实,但其对急诊室整体效率的更广泛影响尚不完全清楚。本研究旨在评估在就诊后1小时内进行的早期PoCUS与非创伤性腹痛成人患者的急诊室患者流程、医疗资源利用及医疗质量之间的关联。这项回顾性队列研究纳入了2021年1月至2023年12月期间因非创伤性腹痛就诊的44863例成年患者(≥18岁)。患者被分为接受PoCUS组和未接受PoCUS组,并对在1小时内接受PoCUS的患者进行亚组分析,以评估急诊室住院时间以及不同急诊处置的费用。测量的结果包括住院时间、费用、死亡率和重症监护病房(ICU)入住情况。受试者的平均年龄为44.4±17.9岁,61.2%为女性。39.7%的病例进行了PoCUS检查,其中69.6%在1小时内完成。此外,30.5%的患者接受了CT检查。在入住普通病房的患者中,PoCUS组的急诊室住院时间明显短于未接受PoCUS组(<0.001),但在门诊处置(=0.282)或ICU入住(=0.081)方面并非如此。对在1小时内接受PoCUS的患者进行亚组分析显示,门诊处置(<0.001)和普通病房入院(<0.001)的住院时间均明显缩短,对ICU入住无影响(=0.869)。是否进行CT检查并未改变这些结果。多变量分析表明,在首次就诊时仅接受PoCUS检查且在非计划复诊后入院的患者,与直接在首次就诊时入院的患者相比,初始急诊费用更低(-9436.1新台币,<0.001),急诊室住院时间更短(-11.59分钟,<0.001),复诊后总资源利用或不良结局无显著增加。PoCUS,尤其是在1小时内进行时,与门诊处置和住院患者的急诊室住院时间缩短及医疗资源利用减少相关,且不影响患者安全或医疗质量。