Point-of-care ultrasound improves clinical outcomes in patients with acute onset dyspnea : a systematic review and meta-analysis
© 2022. The Author(s)..
The early, appropriate management of acute onset dyspnea is important but often challenging. The aim of this study was to investigate the effects of the use of Point-of-Care Ultrasound (PoCUS) versus conventional management on clinical outcomes in patients with acute onset dyspnea. The Cochrane Library, MEDLINE, EMBASE and reference lists were searched to identify eligible trials (inception to October 14, 2021). There were no language restrictions. Randomized controlled trials (RCTs), and prospective and retrospective cohort studies that compared PoCUS with conventional diagnostic modalities (controls) in patients with acute onset dyspnea were included. Two independent reviewers extracted data and assessed the risk of bias. Disagreements were resolved by consensus. The primary study outcomes were time to diagnosis, time to treatment, and length of stay (LOS). Secondary outcomes included rate of appropriate treatment, 30-day re-admission rate, and mortality. We included eight RCTs and six observational studies with a total of 5393 participants. Heterogeneity across studies was variable (from low to considerable), with overall low or moderate study quality and low or moderate risk of bias (except one article with serious risk of bias). Time to diagnosis (mean difference [MD], - 63 min; 95% CI, - 115 to - 11 min] and time to treatment (MD, - 27 min; 95% CI - 43 to - 11 min) were significantly shorter in the PoCUS group. In-hospital LOS showed no differences between the two groups, but LOS in the Intensive Care Unit (MD, - 1.27 days; - 1.94 to - 0.61 days) was significantly shorter in the PoCUS group. Patients in the PoCUS group showed significantly higher odds of receiving appropriate therapy compared to controls (odds ratio [OR], 2.31; 95% CI, 1.61-3.32), but there was no significant effect on 30-day re-admission rate and in-hospital or 30-day mortality. Our results indicate that PoCUS use contributes to early diagnosis and better outcomes compared to conventional methods in patients admitted with acute onset dyspnea.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
|---|---|
| Enthalten in: |
Internal and emergency medicine - 18(2023), 2 vom: 31. März, Seite 639-653 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Szabó, Gergő Vilmos [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute-onset dyspnea |
|---|
| Anmerkungen: |
Date Completed 20.03.2023 Date Revised 15.07.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s11739-022-03126-2 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM348245734 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM348245734 | ||
| 003 | DE-627 | ||
| 005 | 20231226035727.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s11739-022-03126-2 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1160.xml |
| 035 | |a (DE-627)NLM348245734 | ||
| 035 | |a (NLM)36310302 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Szabó, Gergő Vilmos |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Point-of-care ultrasound improves clinical outcomes in patients with acute onset dyspnea |b a systematic review and meta-analysis |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 20.03.2023 | ||
| 500 | |a Date Revised 15.07.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a The early, appropriate management of acute onset dyspnea is important but often challenging. The aim of this study was to investigate the effects of the use of Point-of-Care Ultrasound (PoCUS) versus conventional management on clinical outcomes in patients with acute onset dyspnea. The Cochrane Library, MEDLINE, EMBASE and reference lists were searched to identify eligible trials (inception to October 14, 2021). There were no language restrictions. Randomized controlled trials (RCTs), and prospective and retrospective cohort studies that compared PoCUS with conventional diagnostic modalities (controls) in patients with acute onset dyspnea were included. Two independent reviewers extracted data and assessed the risk of bias. Disagreements were resolved by consensus. The primary study outcomes were time to diagnosis, time to treatment, and length of stay (LOS). Secondary outcomes included rate of appropriate treatment, 30-day re-admission rate, and mortality. We included eight RCTs and six observational studies with a total of 5393 participants. Heterogeneity across studies was variable (from low to considerable), with overall low or moderate study quality and low or moderate risk of bias (except one article with serious risk of bias). Time to diagnosis (mean difference [MD], - 63 min; 95% CI, - 115 to - 11 min] and time to treatment (MD, - 27 min; 95% CI - 43 to - 11 min) were significantly shorter in the PoCUS group. In-hospital LOS showed no differences between the two groups, but LOS in the Intensive Care Unit (MD, - 1.27 days; - 1.94 to - 0.61 days) was significantly shorter in the PoCUS group. Patients in the PoCUS group showed significantly higher odds of receiving appropriate therapy compared to controls (odds ratio [OR], 2.31; 95% CI, 1.61-3.32), but there was no significant effect on 30-day re-admission rate and in-hospital or 30-day mortality. Our results indicate that PoCUS use contributes to early diagnosis and better outcomes compared to conventional methods in patients admitted with acute onset dyspnea | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Acute-onset dyspnea | |
| 650 | 4 | |a Clinical outcomes | |
| 650 | 4 | |a Point-of-care ultrasound | |
| 700 | 1 | |a Szigetváry, Csenge |e verfasserin |4 aut | |
| 700 | 1 | |a Szabó, László |e verfasserin |4 aut | |
| 700 | 1 | |a Dembrovszky, Fanni |e verfasserin |4 aut | |
| 700 | 1 | |a Rottler, Máté |e verfasserin |4 aut | |
| 700 | 1 | |a Ocskay, Klemetina |e verfasserin |4 aut | |
| 700 | 1 | |a Madzsar, Stefanie |e verfasserin |4 aut | |
| 700 | 1 | |a Hegyi, Péter |e verfasserin |4 aut | |
| 700 | 1 | |a Molnár, Zsolt |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Internal and emergency medicine |d 2006 |g 18(2023), 2 vom: 31. März, Seite 639-653 |w (DE-627)NLM165086432 |x 1828-0447 |7 nnns |
| 773 | 1 | 8 | |g volume:18 |g year:2023 |g number:2 |g day:31 |g month:03 |g pages:639-653 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s11739-022-03126-2 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 18 |j 2023 |e 2 |b 31 |c 03 |h 639-653 | ||