Incidental Renal Cysts Found by Point-of-Care Ultrasound: A Retrospective Chart Review

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
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引用次数: 0

Abstract

Background

Incidental findings are unrelated to a patient's complaint, found on diagnostic imaging, such as point-of-care ultrasound (POCUS). Incidental findings represent potential harms to patients and may lead to increased patient anxiety and health care costs related to downstream testing and surveillance.

Study Objectives

In this study, we aimed to calculate the rate of incidental renal cysts found by POCUS. Further, we hoped to describe how emergency physicians relay the findings to patients. Lastly, we hoped to examine if patients suffered harms in the 12 months following identification of an incidental renal cyst.

Methods

From our single-center, academic emergency department (ED), we reviewed renal POCUS images from 1000 consecutive adult ED patients to determine if there was a renal cyst. Next, we performed manual chart review to determine if patients were informed of the incidental renal cyst or suffered any patient harms.

Results

We found the prevalence of renal cysts to be 6.5% (95% confidence interval: 4.9%–8.4%). Those with cysts were more likely to be older compared to those without (63 ± 14 vs. 49 ± 15 years of age). Only 8% of patients had evidence that they were informed of their incidental renal cyst. No patients received a biopsy or were diagnosed with renal cell carcinoma or polycystic kidney disease.

Conclusion

Incidental renal cysts are common and are more likely to be found in older adults. In our study, physicians infrequently informed patients of their incidental finding.

超声在急诊医学中的应用--床旁超声发现的肾囊肿:病历回顾
研究背景偶然发现是指在诊断成像(如床旁超声检查(POCUS))中发现的与患者主诉无关的结果。意外发现对患者造成了潜在的伤害,并可能导致患者焦虑增加以及与下游检测和监控相关的医疗费用增加。研究目的在这项研究中,我们旨在计算 POCUS 意外发现肾囊肿的比率。此外,我们还希望描述急诊医生如何向患者转达检查结果。最后,我们希望研究患者在发现偶发肾囊肿后的 12 个月内是否受到了伤害。方法在我们的单中心学术急诊科(ED)中,我们查看了 1000 名连续的 ED 成人患者的肾脏 POCUS 图像,以确定是否存在肾囊肿。接下来,我们进行了人工病历审查,以确定患者是否被告知偶发肾囊肿或是否受到任何患者伤害。结果我们发现肾囊肿的发病率为 6.5%(95% 置信区间:4.9%-8.4%)。与无囊肿的患者相比,有囊肿的患者年龄更大(63 ± 14 岁对 49 ± 15 岁)。只有8%的患者有证据表明,他们被告知自己患有偶发性肾囊肿。没有患者接受活组织检查或被诊断为肾细胞癌或多囊肾。在我们的研究中,医生很少告知患者其偶然发现。
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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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