Document Detail

Transthoracic echocardiography: impact on diagnosis and management in tertiary care intensive care units.
MedLine Citation:
PMID:  16119491     Owner:  NLM     Status:  MEDLINE    
The purpose of this study was to evaluate the utility of transthoracic echocardiography (TTE) in an intensive care unit by determining its impact on diagnosis and management. Over a six-month time period, we performed a prospective observational study on all patients admitted to either the medical or the surgical intensive care unit. Structured interviews were conducted with referring physicians before and after the TTE to determine the referring physicians' pre-TTE diagnosis, reasons for requesting the TTE, and whether the TTE resulted in a change in diagnosis and/or management. A total of 135 TTE examinations were done in 126 patients. The referring physicians deemed that clinical information was inadequate to make a definitive diagnosis and management plan in 36/135 (27%) of the requests. In 99/135 (73%) studies, physicians indicated that there was probably sufficient clinical information to formulate a diagnosis and management plan, but ordered a TTE to corroborate their clinical findings. Overall, a change in diagnosis occurred in 39/135 (29%) of studies, and a change in management in 55/135 (41%) of studies. Diagnosis was changed in 19/99 (19%) studies with adequate clinical data, and in 20/36 (56%) studies with inadequate clinical data (P<0.001). Management was changed in 34/99 (34%) of studies with adequate clinical data and in 21/36 (58%) of studies with inadequate clinical data (P=0.017). Of the 62 management changes, 57/62 (92%) changes were minor, and 5/62 (8%) were major. In conclusion we have found that TTE frequently resulted in a change in the diagnosis and management.
L K Stanko; E Jacobsohn; J W Tam; C J De Wet; M Avidan
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  33     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-25     Completed Date:  2006-02-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  492-6     Citation Subset:  IM    
Department of Anesthesia, Health Science Center, University of Manitoba, Winnipeg, Canada.
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MeSH Terms
Diagnosis, Differential
Echocardiography / methods*,  utilization
Heart Diseases / diagnosis*,  therapy*
Intensive Care Units*
Interviews as Topic
Middle Aged
Prospective Studies
Utilization Review

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