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Ultraschall Med. 2019 Apr 26. doi: 10.1055/a-0889-8070. [Epub ahead of print]

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

Author information

1
Department of Internal Medicine 1, University of Tuebingen, Tuebingen, Germany.
2
Geriatric Department, Klinikum Marbach, Germany.
3
Professorial Research Fellow AITHM, James Cook University, Townsville, Australia.
4
Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.
5
Department of Internal Medicine 1, Klinikum Ludwigsburg, Ludwigsburg, Germany.
6
Department of Women's health, University of Tuebingen, Tuebingen, Germany.
7
Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany.

Abstract

in English, German

PURPOSE:

 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.

MATERIALS AND METHODS:

 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.

RESULTS:

 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.

CONCLUSION:

 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.

PMID:
31026863
DOI:
10.1055/a-0889-8070

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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