Diagnostic accuracy of Point Of Care UltraSound (<scp>POCUS</scp>) in clinical practice: A retrospective, emergency department based study

Spampinato, Michele Domenico; Luppi, Francesco; Cristofaro, Enrico; Benedetto, Marcello; Cianci, Antonella; Bachechi, Tommaso; Ghirardi, Caterina; Perna, Benedetta; Guarino, Matteo; Passaro, Angelina; De Giorgio, Roberto; Sofia, Soccorsa

doi:10.1002/jcu.23619

Cited by 5 publications

(2 citation statements)

References 59 publications

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“…First, it is a retrospective study conducted in a single centre; second, it only included patients who underwent formal TTE, excluding patients who died before formal TTE or who refused hospital admission; third, it did not include all parameters of RV function mentioned in the ESC guidelines [ 3 ]. However, hyperacute formal TTE is rarely performed in the ED, and point-of-care ultrasound (POCUS) [ 28 , 29 ] or focused cardiac ultrasound (FoCUS) [ 30 , 31 ] are more easily implemented in this setting. In our opinion, the prognostic role of POCUS or FOCUS must be evaluated separately from the role of formal TTE, since these three examinations are performed with profoundly different echocardiographic instruments and by different experienced providers.…”

Section: Discussionmentioning

confidence: 99%

The role of echocardiography in pulmonary embolism for the prediction of in-hospital mortality: a retrospective study

Spampinato,

Portoraro,

Sofia

et al. 2024

J Ultrasound

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Purpose Pulmonary Embolism (PE) is the third leading cause of cardiovascular death, following myocardial infarction and stroke. The latest European Society of Cardiology (ESC) guidelines on PE recommend short-term prognostic stratification based on right ventricular (RV) overload detected by transthoracic echocardiography (TTE) or contrast-enhanced chest CT. The aim of the study is to find out which of the signs of right ventricular dysfunction best predicts in-hospital mortality (IHM). Methods This is a monocentric, retrospective study including adult patients admitted from the emergency department with a c-e cCT confirmed diagnosis of PE between January 2018 and December 2022 who underwent a TTE within 48 h. Results 509 patients (median age 76 years [IQR 67–84]) were included, with 7.1% IHM. At univariate analysis, RV/LV ratio > 1 (OR 2.23, 95% CI 1.1–4.5), TAPSE < 17 mm (OR 4.73, 95% CI 2.3–9.8), the D-shape (OR 3.73, 95% CI 1.71–8.14), and LVEF < 35% (OR 5.78, 95% CI 1.72–19.47) resulted significantly correlated with IHM. However, at multivariate analysis including also haemodynamic instability, PESI class > II, and abnormal hs-cTnI levels, only LVEF < 35% (OR 5.46, 95% CI 1.32–22.61) resulted an independent predictor of IHM. Conclusion Despite the recognised role of TTE in the early management of patients with circulatory shock and suspected PE, signs of RV dysfunction have been shown to be poor predictors of IHM, whereas severely reduced LVEF is an independent risk factor for in-hospital death.

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Section: Discussionmentioning

confidence: 99%

The role of echocardiography in pulmonary embolism for the prediction of in-hospital mortality: a retrospective study

Spampinato,

Portoraro,

Sofia

et al. 2024

J Ultrasound

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“…Since then, in many areas of inpatient care, mobile, hand-held, pocked-sized ultrasound devices, which are ideal for binary decision-making on clinical questions, have been gaining ground for many years. Their use is also important in time-sensitive urgent cases for rapid, accurate, noninvasive diagnosis and prompt initiation of de nitive therapy, which facilitates improved clinical outcomes [6,7,8]. The last decade has seen an expansion of point-of-care ultrasonography in family medicine in several countries, but not at nearly the same pace as in inpatient care [9].…”

Section: Introductionmentioning

confidence: 99%

Is it worth trying? A cross-sectional study on the implementation of point-of-care ultrasound in Hungarian primary care

Kiss-Kovács,

Morvai-Illés,

Varga

et al. 2024

Preprint

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Background Although the number of point-of-care ultrasound devices available in Hungarian primary care practices are increasing due to government funding, their use in day-to-day patient care is limited and unregulated. Our study aimed to evaluate the attitudes and needs of general practitioners (GPs) and patients in Hungary regarding the introduction of bedside ultrasonography in primary care practices. Methods As a part of a cross-sectional study, an anonymous, self-administered questionnaire was distributed to GPs and patients on a social media platform. Data collection was carried out from August 2023 to October 2023. Chi-square test was used to determine the associations between patient groups and categorical variables. Results The survey was completed by 415 GPs (mean age 53.8 ± 11.1 years, 54.9% female, mean 19.5 ± 11.9 years of practice) and 693 patients (mean age 45.5 ± 12.3 years, 95.2% female). There was a statistically significant increase in interest in PoCUS among young and middle-aged GPs (age 28–59; p = 0.02). In addition, this population of GPs was also more likely to undertake training in PoCUS than their older colleagues (p < 0.0001). A significant inverse correlation was found between the duration of practice and training willingness (p = 0.0011). Even with the government's financial support, only 8.2% of GPs currently use PoCUS in a daily basis, and 59.5% of GPs are unfamiliar with the indications and the ways of using it. Patients would even pay to have the examination done in a primary care setting, even though only 45.9% of patients would pay a GP who is not certified in PoCUS, but the willingness to pay increased to 99.4% for those with formal training (p = 0.024). Conclusion Our findings indicate a significant interest in adapting PoCUS in primary care from both GPs and patients. Based on the fact that a significant proportion of Hungarian GPs are unaware of PoCUS and its indications, it is particularly important to develop educational frameworks, and practical guidelines for the effective incorporation of PoCUS in Hungary.

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Using point‐of‐care ultrasound to determine incidence of deep vein thrombosis after right‐sided radiofrequency catheter ablation

Qayoom,

Asghar,

Lutfi

et al. 2024

Journal of Arrhythmia

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IntroductionFemoral venous access is routinely used for radiofrequency catheter ablation (RFA) procedures. Deep vein thrombosis (DVT), which is often sub‐clinical, is uncommon following RFCA. Point‐of‐care ultrasound (POCUS) is a cost‐effective way to diagnose DVT. Identification of DVT incidence, especially if sub‐clinical, can direct change in practice to reduce DVT and lay ground for cost‐effective screening strategies postprocedures. The aim of our study is to determine the incidence of DVT after right‐sided radiofrequency cardiac catheter ablation using POCUS.MethodsWe conducted a single‐center prospective cross‐sectional study in patients undergoing right‐sided RFCA. Within 24 h postprocedure, the participants underwent compression venous duplex ultrasonography using POCUS to look for evidence of DVT in cannulated limb. The contralateral limb that was not cannulated was scanned as a control.ResultsA total of 194 patients were scanned post‐right‐sided RFCA procedures. Average age was 43.5 ± 13.2 years and 131 (67.5%) were women. A total of 148 (76.3%) patients underwent AVNRT ablation. Ten (5.2%) patients developed DVT, of which nine had sub‐clinical DVT. Age (>53 years), greater sum of sheaths used (>3) and longer duration of bed rest maintained (up to 4.0 h vs. >4.0 h, p = 0.006) were identified as risk factors.ConclusionMost of the DVTs after right‐sided catheter ablation are sub‐clinical. Routine scanning for DVT after right‐sided catheter ablation as well as reducing number of sheaths and bed rest should be considered.

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Diagnostic accuracy of Point Of Care UltraSound (POCUS) in clinical practice: A retrospective, emergency department based study

Cited by 5 publications

References 59 publications

The role of echocardiography in pulmonary embolism for the prediction of in-hospital mortality: a retrospective study

The role of echocardiography in pulmonary embolism for the prediction of in-hospital mortality: a retrospective study

Is it worth trying? A cross-sectional study on the implementation of point-of-care ultrasound in Hungarian primary care

Using point‐of‐care ultrasound to determine incidence of deep vein thrombosis after right‐sided radiofrequency catheter ablation

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