Impact of an enhanced focused cardiac ultrasound on treatment changes in a population of internal medicine patients

Abstract

AbstractBackgroundHospitalized patients with acute shortness of breath (SOB) could benefit from an enhanced focused cardiac ultrasound (eFoCUS) with Doppler measurements to reassess treatment and diagnosis.MethodsThis was a retrospective observational study performed in a medical ward. Included patients were those hospitalized for acute SOB. The objectives were to assess therapeutic and diagnosis changes associated with eFoCUS. The primary endpoint of the analysis was a composite of introduction or discontinuation of diuretics, antibiotics or anticoagulation following eFoCUS.ResultsBetween January 2018 and July 2021, 119 patients were included, 67 women and 52 men, mean age 84 ± 11 years old. The eFoCUS was performed within a median time of 55 h (1st–3rd IQ: 21–107) following hospital admission. Overall, eFoCUS was associated with a change in diagnostic in 40 patients (34% [CI 95%: 25%–43%], p < 10−4) and a change in treatment in 53 patients (45% [CI 95%: 35%–54%], p < 10−4). Diuretics were prescribed in 94 patients before eFoCUS and in 56 after (p = 10−4), antibiotics in 34 before and 27 after and anticoagulation in 30 before and 40 after.ConclusioneFoCUS was associated with both therapeutic and diagnostic changes in patients with SOB. Such results should be confirmed in multicentric prospective studies.