Usefulness of Multi-Organ Point-of-Care Ultrasound as a Complement to the Decision-Making Process in Internal Medicine

• Published in: Journal of clinical medicine Vol. 11; no. 8; p. 2256
• Main Authors: Casado-López, Irene, Tung-Chen, Yale, Torres-Arrese, Marta, Luordo-Tedesco, Davide, Mata-Martínez, Arantzazu, Casas-Rojo, Jose Manuel, Montero-Hernández, Esther, García De Casasola-Sánchez, Gonzalo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 18.04.2022; MDPI
• Subjects: Abdomen; Auscultation; Clinical medicine; Coronary vessels; COVID-19; Decision making; Heart; Hypothesis testing; Internal medicine; Laboratories; Medicine; Patients; Point of care testing; Software; Ultrasonic imaging; X-rays; internal medicine; abdominal ultrasound; point-of-care ultrasound; lung ultrasound; echocardiography
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11082256

Accumulated data show the utility of diagnostic multi-organ point-of-care ultrasound (PoCUS) in the assessment of patients admitted to an internal medicine ward. We assessed whether multi-organ PoCUS (lung, cardiac, and abdomen) provides relevant diagnostic and/or therapeutic information in patients admitted for any reason to an internal medicine ward. We conducted a prospective, observational, and single-center study, at a secondary hospital. Multi-organ PoCUS was performed during the first 24 h of admission. The sonographer had access to the patients’ medical history, physical examination, and basic complementary tests performed in the Emergency Department (laboratory, X-ray, electrocardiogram). We considered a relevant ultrasound finding if it implied a significant diagnostic and/or therapeutic change. In the second semester of 2019, we enrolled 310 patients, 48.7% were male and the mean age was 70.5 years. Relevant ultrasound findings were detected in 86 patients (27.7%) and in 60 (19.3%) triggered a therapeutic change. These findings were associated with an older age (Mantel−Haenszel χ2 = 25.6; p < 0.001) and higher degree of dependency (Mantel−Haenszel χ2 = 5.7; p = 0.017). Multi-organ PoCUS provides relevant diagnostic information, complementing traditional physical examination, and facilitates therapy adjustment, regardless of the cause of admission. Multi-organ PoCUS to be useful need to be systematically integrated into the decision-making process in internal medicine.