What is the clinical evidence from this study?

Study design: Cohort. Population: Large pericardial effusions or tamponade (n=73). Intervention: Point-of-care ultrasound (POCUS) vs. Diagnosis by other means (non-POCUS). Primary outcome: Time to pericardiocentesis (hours) (p=0.055).

September 28, 2017Clinical and Experimental Emergency MedicineOpen Access

Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions

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Key result

Point-of-care ultrasound in the emergency department reduced the time to pericardiocentesis to 11.3 hours compared to 70.2 hours for patients diagnosed by other means (P=0.055).

Why the study?

Does point-of-care ultrasound (POCUS) reduce time to pericardiocentesis and length of hospital stay in emergency department patients with clinically significant pericardial effusions?

Population

73 non-trauma patients presenting to the emergency department with a diagnosis of large pericardial effusion…

Comparison

Point-of-care ultrasound performed by emergency… vs Diagnosis on the medical wards or incidentally…

Design

Cohort

Follow-up

hospital stay

Authors

EAEvan Avraham AlpertHebrew University of Jerusalem UAUri AmitUniversity of Calgary LGLarisa GurandaSheba Medical Center

Discussion

Member takes

Implication

May support POCUS for ED tamponade detection; hypothesis-generating for outcomes and practice integration.

Study Design

Type

Cohort (n=73)

Multicenter

Structured PICO

Does point-of-care ultrasound (POCUS) reduce time to pericardiocentesis and length of hospital stay in emergency department patients with clinically significant pericardial effusions?

Population

73 non-trauma patients with large pericardial effusions or tamponade evaluated in a single emergency department over a 4.5-year period.

Exposure

Point-of-care ultrasound (POCUS) performed by emergency physicians in the emergency department to identify clinically significant pericardial effusion.

Comparator

Diagnosis on the medical wards or incidentally in the emergency department by other means such as computed tomography (non-POCUS group).

Outcome

Door-to-pericardiocentesis time, amount of pericardiocentesis fluid, and length of hospital stay.

Main Result

Absolute Event Rate: 11.3% vs 70.2%

p-value: p=0.055

Emergency department point-of-care ultrasound for suspected pericardial effusion may reduce time to pericardiocentesis and hospital length of stay.

Limitations

Lack of clear criteria for the decision of who needs POCUS, potentially resulting in selection bias
Utility of POCUS is skill-dependent
Single-center study design limits generalizability
Lack of clear criteria for the decision of who needs POCUS to identify tamponade or a large pericardial effusion, potentially resulting in selection bias
Single-center study

Cite This Study

Alpert et al. (2017) conducted a cohort in Large pericardial effusions or tamponade (n=73). Point-of-care ultrasound (POCUS) vs. Diagnosis by other means (non-POCUS) was evaluated on Time to pericardiocentesis (hours) (p=0.055). Point-of-care ultrasound in the emergency department reduced the time to pericardiocentesis to 11.3 hours compared to 70.2 hours for patients diagnosed by other means (P=0.055).

synapsesocial.com/papers/6a93fa202fda98a11521515f https://doi.org/10.15441/ceem.16.169

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Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider