Clinical Impact of Point-of-Care Ultrasound in Internal Medicine Inpatients: A Systematic Review

Ximena Cid-Serra; William Hoang; Doa El-Ansary; David Canty; Alistair Royse; Colin Royse

doi:10.1016/j.ultrasmedbio.2021.09.013

Clinical Impact of Point-of-Care Ultrasound in Internal Medicine Inpatients: A Systematic Review

Ultrasound Med Biol. 2022 Feb;48(2):170-179. doi: 10.1016/j.ultrasmedbio.2021.09.013. Epub 2021 Nov 2.

Authors

Ximena Cid-Serra¹, William Hoang², Doa El-Ansary³, David Canty⁴, Alistair Royse⁵, Colin Royse⁶

Affiliations

¹ Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Department of Medicine and Community Care, Royal Melbourne Hospital, Melbourne, VIC, Australia. Electronic address: Ximena.cid@heartweb.com.
² Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.
³ Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, Melbourne, VIC, Australia; Clinical Research Institute, Westmead Private Hospital, Westmead, Sydney, NSW, Australia.
⁴ Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Department of Medicine, Monash University, Melbourne, VIC, Australia; Department of Anaesthesia and Perioperative Medicine, Monash Health, Melbourne, VIC, Australia.
⁵ Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Department of Surgery, the Royal Melbourne Hospital, Melbourne, VIC, Australia.
⁶ Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH.

PMID: 34740496
DOI: 10.1016/j.ultrasmedbio.2021.09.013

Abstract

The aim in this systematic review was to determine the effect of point-of-care ultrasound (POCUS) on the clinical decision-making process and patient outcomes in adults admitted to the general medicine ward. A comprehensive search was performed in MEDLINE (Ovid), EMBASE (Ovid), PubMed, the Cochrane Library, ClinicalTrials.gov, Scopus, LILACS and Cinahl. Articles had to fulfill the inclusion criteria of randomised or non-randomised studies assessing the impact of POCUS on the diagnosis, management, length of hospital stay or mortality of patients admitted to the internal medicine ward. Six studies were included involving a total of 1836 patients. The influence of POCUS on the diagnosis was reported as a change in the main diagnosis or the addition of a relevant diagnosis in up to 18% and 24% of the cases, respectively. Impact on the management plan was reported in 37% to 52.1% of the participants. Three studies documented the impact of POCUS on the length of stay. Two of them reported no difference between groups, and the other reported a significant reduction of 1 d of the hospital stay. In conclusion, POCUS appears to have positive effects on the clinical decision-making process with impacts on optimal patient management and possible reduction in the hospital length of stay.

Keywords: Decision making; Internal medicine; POCUS; Point-of-care ultrasound; Ultrasonography.

Publication types

Review
Systematic Review

MeSH terms

Adult
Humans
Inpatients*
Length of Stay
Point-of-Care Systems*
Point-of-Care Testing
Ultrasonography