Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea-Protocol for A Randomized Controlled Trial.

IF 1.5 Q3 EMERGENCY MEDICINE Open Access Emergency Medicine Pub Date : 2024-08-27 eCollection Date: 2024-01-01 DOI:10.2147/OAEM.S454062
Stig Holm Ovesen, Søren Helbo Skaarup, Rasmus Aagaard, Hans Kirkegaard, Bo Løfgren, Michael Dan Arvig, Bo Martin Bibby, Stefan Posth, Christian B Laursen, Jesper Weile
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引用次数: 0

Abstract

Purpose: Point-of-care ultrasound (POCUS) helps emergency department (ED) physicians make prompt and appropriate decisions, but the optimal diagnostic integration and potential clinical benefits remain unclear. We describe the protocol and statistical analysis plan for a randomized controlled trial. The objective is to determine the effect of a POCUS-driven diagnostic pathway in adult dyspneic ED patients on the proportion of patients having a hospital stay of less than 24 hours when compared to the standard diagnostic pathway.

Patients and methods: This is a multicenter, randomized, investigator-initiated, open-labeled, pragmatic, controlled trial. Adult ED patients with chief complaint dyspnea are eligible. Patients are randomized (1:1) to the POCUS-driven diagnostic pathway or standard diagnostic pathway, with 337 patients in each group. The primary outcome is the proportion of patients having a hospital stay (from ED arrival to hospital discharge) of less than 24 hours. Key secondary outcomes include hospital length-of-stay, 72-hour revisits, and 30-day hospital-free days.

Conclusion: Sparse evidence exists for any clinical benefit from a POCUS-integrated diagnostic pathway. The results from this trial will help clarify the promising signals for POCUS to influence patient care among ED patients with dyspnea.

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护理点超声与标准诊断路径对急诊科呼吸困难患者 24 小时住院时间的影响--随机对照试验方案。
目的:床旁超声(POCUS)可帮助急诊科(ED)医生做出迅速而适当的决策,但最佳诊断整合和潜在临床益处仍不明确。我们介绍了一项随机对照试验的方案和统计分析计划。目的是确定与标准诊断路径相比,POCUS 驱动的诊断路径对成人呼吸困难急诊科患者住院时间少于 24 小时的比例的影响:这是一项由研究者发起的多中心、随机、开放标签、实用对照试验。主诉呼吸困难的成人急诊患者均符合条件。患者按 1:1 随机分配到 POCUS 驱动诊断路径或标准诊断路径,每组 337 名患者。主要结果是住院时间(从急诊室到达到出院)少于 24 小时的患者比例。主要次要结果包括住院时间、72小时复诊率和30天无住院天数:结论:目前尚无充分证据表明 POCUS 综合诊断路径可带来任何临床益处。这项试验的结果将有助于明确 POCUS 在影响急诊室呼吸困难患者护理方面的前景。
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来源期刊
Open Access Emergency Medicine
Open Access Emergency Medicine EMERGENCY MEDICINE-
CiteScore
2.60
自引率
6.70%
发文量
85
审稿时长
16 weeks
期刊最新文献
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