Point of Care Ultrasound in Geriatric Patients: Prospective Evaluation of a Portable Handheld Ultrasound Device

• Published in: Ultraschall in der Medizin Vol. 41; no. 3; p. 308
• Main Authors: Fröhlich, Eckhart, Beller, Katharina, Muller, Reinhold, Herrmann, Maria, Debove, Ines, Klinger, Christoph, Pauluschke-Fröhlich, Jan, Hoffmann, Tatjana, Kreppenhofer, Sorina, Dietrich, Christoph F
• Format: Journal Article
• Language: English
• Published: Germany 01.06.2020
• Subjects: Abdomen - diagnostic imaging; Aged; Humans; Point-of-Care Systems; Prospective Studies; Sensitivity and Specificity; Ultrasonography
• ISSN: 1438-8782
• DOI: 10.1055/a-0889-8070

The aim of the current study was to evaluate point of care ultrasound (POCUS) in geriatric patients by echoscopy using a handheld ultrasound device (HHUSD, VScan) at bedside in comparison to a high-end ultrasound system (HEUS) as the gold standard.  Prospective observational study with a total of 112 geriatric patients. The ultrasound examinations were independently performed by two experienced blinded examiners with a portable handheld device and a high-end ultrasound device. The findings were compared with respect to diagnostic findings and therapeutic implications.  The main indications for the ultrasound examinations were dyspnea (44.6 %), fall (frailty) (24.1 %) and fever (21.4 %). The most frequently found diagnoses were cystic lesions 32.1 % (35/109), hepatic vein congestion 19.3 % (21/109) and ascites 13.6 % (15/110). HHUSD delivered 13 false-negative findings in the abdomen resulting in an "overall sensitivity" of 89.5 %. The respective "overall specificity" was 99.6 % (7 false-positive diagnoses). HHUSD (versus HEUS data) resulted in 13.6 % (17.3 %) diagnostically relevant procedures in the abdomen and 0.9 % (0.9 %) in the thorax. Without HHUSD (HEUS) 95.7 % (100 %) of important pathological findings would have been missed.  The small HHUSD tool improves clinical decision-making in immobile geriatric patients at the point of care (geriatric ward). In most cases, HHUSD allows sufficiently accurate yes/no diagnoses already at the bedside, thereby clarifying the leading symptoms for early clinical decision-making.