比较即时超声和常规分诊对急诊科腹痛患者的疗效。

IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Mehmet Alperen Biçer, Necip Gökhan Güner, Onur Karakayalı, Sacit Akdeniz, Yusuf Yürümez, Murat Özsaraç, Fatih Güneysu
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引用次数: 0

摘要

腹痛约占所有急诊科(ED)表现的10%,是一种常见且诊断复杂的主诉。即时超声(POCUS)已成为急诊科必不可少的工具,支持复苏、介入程序、诊断和随访。这项前瞻性、随机对照研究旨在评估pocus综合分诊与传统分诊(无超声)对非外伤性腹痛患者诊断准确性、治疗开始和ED管理的影响。共纳入262例成人患者,采用计算机辅助方法按1:1比例随机分组,其中127例分配给传统分诊,135例分配给POCUS分诊。研究人员没有干预临床决策。主要结果包括额外的成像要求、初始镇痛时间、咨询要求、急诊科住院时间和总体结果,而次要结果是对分诊分类的影响。采用IBM SPSS Statistics version 21.0进行统计分析。参与者的平均年龄为30岁,其中55.7%为女性。POCUS分诊组需要的额外影像学检查明显减少(p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing the effectiveness of point-of-care ultrasound and conventional triage in patients presenting to the emergency department with abdominal pain.

Abdominal pain constitutes approximately 10% of all emergency department (ED) presentations, representing a frequent and diagnostically complex complaint. Point-of-care ultrasound (POCUS) has become an essential tool in the ED, supporting resuscitation, interventional procedures, diagnosis, and follow-up. This prospective, randomized-controlled study aimed to assess the impact of POCUS-integrated triage compared to conventional triage (without ultrasound) on diagnostic accuracy, treatment initiation, and ED management in patients with non-traumatic abdominal pain. A total of 262 adult patients were enrolled and randomized in a 1:1 ratio using computer-assisted methods, with 127 allocated to conventional triage and 135 to POCUS triage. The researcher did not intervene in clinical decisions. Primary outcomes included additional imaging requests, time to initial analgesia, consultation requests, ED length of stay, and overall outcome, while the secondary outcome was the effect on triage categorization. Statistical analysis was performed using IBM SPSS Statistics version 21.0. The mean age of participants was 30 years, with 55.7% being female. The POCUS triage group required significantly fewer additional imaging studies (p < 0.001) and had shorter times to analgesia administration, consultation, and ED discharge (all p < 0.001). Moreover, POCUS triage significantly altered patient categorization compared to the Emergency Severity Index (ESI) system (p < 0.001). When compared against final imaging reports, POCUS demonstrated a sensitivity of 87%, specificity of 55%, positive predictive value of 81.6%, and negative predictive value of 64.7%. In conclusion, POCUS triage enhances clinical efficiency by reducing imaging needs and expediting key interventions, offering significant advantages for emergency department workflow and patient care.

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来源期刊
Internal and Emergency Medicine
Internal and Emergency Medicine 医学-医学:内科
CiteScore
7.20
自引率
4.30%
发文量
258
审稿时长
6-12 weeks
期刊介绍: Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.
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