Inferior vena cava parameters predict re‐admission in ischaemic heart failure

Carbone, Federico; Bovio, Marta; Rosa, Gian Marco; Ferrando, Fabio; Scarrone, Alberto; Murialdo, Giovanni; Quercioli, Alessandra; Vuilleumier, Nicolas; Mach, François; Viazzi, Francesca; Montecucco, Fabrizio

doi:10.1111/eci.12238

Cited by 29 publications

(31 citation statements)

References 49 publications

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“…Furthermore, in an age where hospital readmission rates are closely monitored, IVC ultrasound by residents can be predictive and preventative, reducing rates from 30 to 4% in one recent study (44). Other studies have shown similar predictive power (45, 46). Razi et al (39) demonstrated how residents are able to perform POC echocardiography not only accurately but also nearly a full 24 h before formal echocardiogram results are available to confirm their findings.…”

Section: Discussionsupporting

confidence: 63%

Point-of-care ultrasonography as a training milestone for internal medicine residents: the time is now

Sabath

Singh

2016

Journal of Community Hospital Internal Medicine Perspectives

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Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution – a community hospital – in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes. We also review the growing evidence of the application of ultrasound in the diagnosis of a myriad of conditions encountered in general internal medicine as well as the mounting data on the ability of internal medicine residents to apply this technology accurately at the bedside. We advocate that the literature has sufficiently established the role of POC ultrasonography in general internal medicine that there should no longer be any delay in giving this an official place in the development of internal medicine trainees. This may be particularly useful in the community hospital setting where 24-h echocardiography or other sonography may not be readily available.

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Section: Discussionsupporting

confidence: 63%

Point-of-care ultrasonography as a training milestone for internal medicine residents: the time is now

Sabath

Singh

2016

Journal of Community Hospital Internal Medicine Perspectives

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“…This result may simply reflect that a larger IVC represents a group of heart failure patients with a poorer prognosis [29–32]. Another paper found that IVC size at discharge predicted readmission in ADHF patients, but failed to compare other bedside parameters [33]. If IVC is to be useful in ADHF patients it will need to outperform simpler methods such as physical examination and patient symptoms.…”

Section: Discussionmentioning

confidence: 99%

Results of ACCORDIAN in ACCORD with lower blood pressure begetting lower mortality in patients with diabetes

Laffin

Bakris

2018

Diabetes Obesity Metabolism

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Acute decompensated heart failure (ADHF) is a common reason for admission to the hospital, and readmission is frequent. Multiple factors contribute to rehospitalizations, but inadequate assessment of volume status leading to persistent congestion is an important factor. We sought to determine if focused cardiac ultrasound (FCU) of the inferior vena cava (IVC), as a surrogate of volume status, would predict readmission of ADHF patients after index hospitalization. Patients admitted with a primary diagnosis of ADHF were prospectively enrolled. All patients underwent FCU of the IVC on admission and then daily. 82 patients were enrolled. Patients demonstrated improvement in heart failure physical examination findings and symptoms during the hospitalization. There was a reduction in the size of the IVC and a significant increase in patients with small collapsible vena cava. Logistic regression analysis of physical examination, patient symptoms, and IVC parameters at discharge demonstrated IVC collapsibility and patient reported dyspnea improvement as the only significant variables to predict readmission or emergency department visit. FCU assessment of IVC size and collapsibility may be useful in patients with ADHF to predict risk of being readmitted within 30 days of hospital discharge.

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“…2,[12][13][14][15][16] In general, increased IVC diameter (>2 cm) and decreased collapsibility (<one-third) correlate with hypervolemia, which suggests further benefit of fluid removal. These measurements can be obtained easily with high inter-rater reliability and are more predictive of adverse events than traditional methods like jugular venous distension, lower extremity edema, and serial weights.…”

Section: How Can Bedside Ultrasonography Be Used To Guide Fluid Removal?mentioning

confidence: 99%

“…12 Bedside ultrasonography examinations of the lungs and inferior vena cava (IVC) have been shown to be better than traditional history and physical examination at predicting adverse outcomes in patients with heart failure. [13][14][15][16] Although bedside ultrasonography can be used to examine most systems in the body, the ones that are most applicable to hospitalists include heart, lungs, kidneys, bladder, soft tissue, vasculature, and musculoskeletal system.…”

Section: What Specific Systems Can Bedside Ultrasonography Evaluate?mentioning

confidence: 99%

“…[12][13][14][15] As an example, the cardiopulmonary limited ultrasonography examination incorporates 4 bedside ultrasonography findings (apical B lines, IVC plethora, left ventricular dysfunction, and left atrial enlargement) to predict mortality in hospitalized patients. Patients with all 4 findings had a 21% inpatient mortality, whereas patients with no findings only had a 1% inpatient mortality.…”

Section: How Can Bedside Ultrasonography Be Used For Screening and Rimentioning

confidence: 99%

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Bedside Ultrasonography Applications for Hospitalists

Croffoot

Kittai

Berry

2017

Hospital Medicine Clinics

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Inferior vena cava parameters predict re‐admission in ischaemic heart failure

Abstract: This pilot study showed a higher early re-admission rate in patients with HF due to IHD. In addition, the change in IVC min diameter from admission to discharge was the best predictor of re-admission in patients with IHD.

Cited by 29 publications

References 49 publications

Point-of-care ultrasonography as a training milestone for internal medicine residents: the time is now

Point-of-care ultrasonography as a training milestone for internal medicine residents: the time is now

Results of ACCORDIAN in ACCORD with lower blood pressure begetting lower mortality in patients with diabetes

Bedside Ultrasonography Applications for Hospitalists

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