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Ray, Patrick; Birolleau, Sophie; Lefort, Yannick; Becquemin, M.H.; Beigelman, Catherine; Isnard, Richard; Teixeira, Antônio R. L.; Arthaud, M; Riou, Bruno; Boddaert, Jacques

doi:10.1186/cc4926

Cited by 300 publications

(129 citation statements)

References 32 publications

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“…This is an interesting finding because it may not reflect physiological aging but it possibly indicates a high number of non-identified morbidity in this age group. This would be in line with the high percentage of undetected pulmonary embolisms in this age group, as was found in a recent study of older persons presenting with acute respiratory failure to the emergency department [34].…”

Section: Discussionsupporting

confidence: 88%

Can Echocardiographic Findings Predict Falls in Older Persons?

et al. 2007

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BackgroundThe European and American guidelines state the need for echocardiography in patients with syncope. 50% of older adults with syncope present with a fall. Nonetheless, up to now no data have been published addressing echocardiographic abnormalities in older fallers.Method and FindingsIn order to determine the association between echocardiographic abnormalities and falls in older adults, we performed a prospective cohort study, in which 215 new consecutive referrals (age 77.4, SD 6.0) of a geriatric outpatient clinic of a Dutch university hospital were included. During the previous year, 139 had experienced a fall. At baseline, all patients underwent routine two-dimensional and Doppler echocardiography. Falls were recorded during a three-month follow-up. Multivariate adjustment for confounders was performed with a Cox proportional hazards model. 55 patients (26%) fell at least once during follow-up. The adjusted hazard ratio of a fall during follow-up was 1.35 (95% CI, 1.08–1.71) for pulmonary hypertension, 1.66 (95% CI, 1.01 to 2.89) for mitral regurgitation, 2.41 (95% CI, 1.32 to 4.37) for tricuspid regurgitation and 1.76 (95% CI, 1.03 to 3.01) for pulmonary regurgitation. For aortic regurgitation the risk of a fall was also increased, but non-significantly (hazard ratio, 1.57 [95% CI, 0.85 to 2.92]). Trend analysis of the severity of the different regurgitations showed a significant relationship for mitral, tricuspid and pulmonary valve regurgitation and pulmonary hypertension.ConclusionsEcho(Doppler)cardiography can be useful in order to identify risk indicators for falling. Presence of pulmonary hypertension or regurgitation of mitral, tricuspid or pulmonary valves was associated with a higher fall risk. Our study indicates that the diagnostic work-up for falls in older adults might be improved by adding an echo(Doppler)cardiogram in selected groups.

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Section: Discussionsupporting

confidence: 88%

Can Echocardiographic Findings Predict Falls in Older Persons?

et al. 2007

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“…In addition to this an algorithm, adapted from Emergency Echocardiography by Adrian Chenzbraun [15], was completed if major diagnostic findings were found. The reviewing physician was asked to complete a proforma recording: 4 The presumptive diagnosis, …”

Section: Procedures and Outcomesmentioning

confidence: 99%

“…Causes include primary lung or cardiac conditions, shock or metabolic causes. To confuse the clinician further the aetiology may be multifactorial and therefore treating the wrong cause may exacerbate the condition [4]. We know from autopsy studies that misdiagnosis occurs in 30-50% of patients [4,5] and improvements need to be made.…”

Section: Introductionmentioning

confidence: 99%

Pocket-sized point-of-care cardiac ultrasound devices

Colclough

Nihoyannopoulos

2017

Herz

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“…Acute respiratory failure and dyspnoea are two major causes of hospitalization and key symptoms of several lung diseases as well as diseases in other organ systems [1, 2]. Determining the underlying disease that causes respiratory symptoms can be challenging and involves considerations based on knowledge obtained from medical examinations, a patient’s history, biochemical samples, and radiological imaging.…”

Section: Introductionmentioning

confidence: 99%

Developing and Gathering Validity Evidence for a Simulation-Based Test of Competencies in Lung Ultrasound

et al. 2018

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Background: Clinical lung ultrasound (LUS) is a fast bedside diagnostic tool which can assist clinicians in decisions regarding the treatment and monitoring of patients with respiratory symptoms. LUS training and education differ widely, and is often done in a clinical setting, with potential risks for patients if decisions are made based on the wrong interpretations. No clear guidelines or recommendations for objective and standardized assessment of LUS skills exist, and those that do are often based on a fixed time-frame or an arbitrary number of examinations performed; this does not ensure adequate competencies. Objectives: The study aimed to develop and gather validity evidence for a practical, simulation-based test in LUS. Methods: Nine cases were developed in collaboration with 3D Systems Healthcare, Littleton, CO, USA, representing the most common diagnosis and sonographic findings in patients with respiratory symptoms. Thirty-six participants with different levels of competence in LUS, completed the test. The participants were divided into groups, i.e., novices, intermediates, and experienced, according to their experience with LUS, the number of examinations they had performed, and any research they had conducted. Their answers were used for item analyses. Results: The intraclass correlation coefficient, Cronbachs’ α, was 0.69 summarized, and there was a statistically significant difference (p < 0.001) between the novices and the trained participants (intermediates and experienced). A pass/fail score of 16 points was calculated according to the contrasting-groups method. Conclusion: We developed a test for the assessment of clinical competencies in LUS. The test proved solid validity evidence, and a pass/fail standard without any false-negatives, and only 2 explained false-positives.

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Abstract: Introduction Our objectives were to determine the causes of acute respiratory failure (ARF) in elderly patients and to assess the accuracy of the initial diagnosis by the emergency physician, and that of the prognosis.

Cited by 300 publications

References 32 publications

Can Echocardiographic Findings Predict Falls in Older Persons?

Can Echocardiographic Findings Predict Falls in Older Persons?

Pocket-sized point-of-care cardiac ultrasound devices

Developing and Gathering Validity Evidence for a Simulation-Based Test of Competencies in Lung Ultrasound

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