Photo Credit: Pornpak Khunatorn

The following is a summary of “Point of care ultrasound impact in acute heart failure hospitalization: A retrospective cohort study,” published in the April 2023 issue of Emergency Medicine by Ramos, et al.

One of the most common reasons people attend the emergency room (ED) is acute decompensated heart failure (ADHF). A trustworthy, user-friendly, and readily accessible technology for a precise diagnosis of ADHF is point-of-care ultrasound (POCUS). For a study, researchers sought to examine the effects of adding POCUS as a supplemental diagnostic tool to standard clinical diagnosis in clinical settings involving hospitalized heart failure patients.

The retrospective cohort study compared patients with acute heart failure decompensation who received standard clinical diagnosis without POCUS to those who received an ultrasound-guided diagnosis upon admission. The cumulative incidence functions were calculated for time to treatment, disposition decision, and discharge. A flexible parametric model was used to estimate the time ratio (TR) reflecting the effect of POCUS.

A total of 149 patients were included, with hypertension being the most frequent comorbid condition (71.8%), followed by type 2 diabetes (36.2%). The B-type natriuretic peptide (BNP) was over 500 ng/ml, and most patients had a Stevenson B profile (83.9%) at admission. In the cumulative incidence model, the TR for time to treatment was 1.539 (CI 95% 0.88 to 2.69), indicating increased time to treatment with POCUS. The TR for the time to disposition decision was 0.665 (CI 95% 0.48 to 0.99), suggesting a decrease in the time to disposition decision with POCUS. The TR for the outcome time to discharge (hospital length of stay) was 0.663 (CI 95% 0.49 to 0.90), indicating decreased hospital length of stay with POCUS.

The introduction of POCUS for ADHF patients in the study resulted in a decreased time to disposition decision and a shorter hospital length of stay. However, the time to treatment increased. Using ultrasound as an intervention in clinical trials was needed to confirm the findings.

Source: sciencedirect.com/science/article/pii/S0735675723000517