Document Detail


Influence of hand-carried ultrasound on bedside patient treatment decisions for consultative cardiology.
MedLine Citation:
PMID:  14712187     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To test the hypothesis that hand-carried ultrasound (HCU) may influence patient treatment on consultative cardiology rounds, 235 patients who were hospitalized (aged 65 +/- 10 years) were studied. First, routine treatment decisions regarding diagnostic workup and therapy were made from patient history, physical examination, 12-lead electrocardiogram, and chart data. Second, a goal-directed HCU study was performed in <10 minutes focusing on left ventricular global and regional function, wall thickness, and presence of pericardial effusion, followed by a reassessment of treatment decisions. HCU data influenced treatment decisions in 149 patients (63%); 50% had a change in medical therapy and 22% had a change in their diagnostic workup (most with changes in both). In all, 12 patients (5%) had an immediate change in the decision for cardiac catheterization or pericardiocentesis. Overall agreement for the above findings with subsequent full-size system echocardiography ranged from 92% to 100% (kappa 0.91-0.96). Goal-directed HCU has the potential to influence bedside patient treatment decisions and expedite health care.
Authors:
John Gorcsan; Prasant Pandey; L Elif Sade
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  17     ISSN:  0894-7317     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-08     Completed Date:  2004-04-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  50-5     Citation Subset:  IM    
Affiliation:
University of Pittsburgh, Scaife Hall S-564, 200 Lothrop St, Pittsburgh, PA 15213, USA. gorcsanj@msx.upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiology*
Decision Making*
Electrocardiography*
Equipment Design
Female
Humans
Hypertrophy, Left Ventricular / physiopathology,  ultrasonography
Male
Middle Aged
Pericardial Effusion / physiopathology,  ultrasonography
Point-of-Care Systems*
Referral and Consultation*
Risk Assessment
Severity of Illness Index
Stroke Volume / physiology
Ventricular Dysfunction, Left / physiopathology,  ultrasonography
Grant Support
ID/Acronym/Agency:
K24 HL04503-01/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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