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Master Thesis

Évaluation de l’impact d’un bilan échographique clinique systématique à l’admission des patients en court séjour gériatrique

Abstract : Objectives: The ageing of the population raises new challenges to geriatric care. New screening procedures must be developed to facilitate early diagnosis of chronic and evolving diseases in this patient group. Our focus was to evaluate the value of using point-of-care ultrasound (POCUS) as a screening test in geriatrics.
Design and Setting: We performed a prospective, observational study in a short-term geriatric unit in the University Hospital of Nice from November 2, 2016 until April 30, 2017.
Participants: All patients admitted in the unit were proposed for inclusion, regardless of their history and the reason of their admission.
Intervention: One operator, blinded to the patient’s history, performed all the POCUS scans using a hand carried ultrasound device. A strict protocol was followed, screening a total of 13 organs.
Measurements: Expert committees of geriatricians judged the impact of the screening for each patient: positive impact (short-term or long-term) no impact, or negative impact. We collected the medical history data, and calculated the Charlson’s comorbidity index, to search for predictive factors of positive impact.
Results: In our population of 501 patients, the POCUS screening had a short-term impact for 177 patients (35%), a long-term impact for 116 patients (23%), and a total of 293 with a positive impact (58%). Negative impact only concerned 4 patients (1%). No predictive factors of positive impact were found in the data we collected. Our protocol did not increase the length of stay of the patients (P=0.62).
Conclusion: A POCUS protocol can efficiently screen 13 organs in less than 15 minutes, and proved to have a positive impact on the care of 58% of the patients. Geriatricians should seize the opportunity to include POCUS as a part of their daily practice to improve diagnostic accuracy in routine geriatric care.
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Master Thesis
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Submitted on : Tuesday, October 22, 2019 - 3:47:51 PM
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Nicolas Azulay. Évaluation de l’impact d’un bilan échographique clinique systématique à l’admission des patients en court séjour gériatrique. Médecine humaine et pathologie. 2018. ⟨dumas-02326763⟩



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