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

Fröhlich, Eckhart; Beller, Katharina; Muller, Reinhold; Herrmann, Maria; Debove, Ines; Klinger, Christoph; Pauluschke-Fröhlich, Jan; Hoffmann, Tatjana; Kreppenhofer, Sorina; Dietrich, Christoph F (2020). Point of Care Ultrasound in Geriatric Patients: Prospective Evaluation of a Portable Handheld Ultrasound Device. Ultraschall in der Medizin, 41(3), pp. 308-316. Thieme 10.1055/a-0889-8070

Text Froehlich, 2019, Point of Care Ultrasound.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (319kB)

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.

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5 Citations in Web of Science ®
6 Citations in Scopus

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