Focused cardiac ultrasound (FOCUS) by emergency medicine residents in patients with suspected cardiovascular diseases

被引：34

作者：

Farsi D. ^{[1
]}

Hajsadeghi S. ^{[2
]}

Hajighanbari M.J. ^{[1
]}

Mofidi M. ^{[1
]}

Hafezimoghadam P. ^{[1
]}

Rezai M. ^{[1
]}

Mahshidfar B. ^{[1
]}

Abiri S. ^{[1
]}

Abbasi S. ^{[3
]}

机构：

[1] Emergency Department, Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran

[2] Cardiology Department, Iran University of Medical Sciences, Tehran

[3] Emergency Department, Hazrat-Rasool Hospital, Iran University of Medical Sciences, Niayesh St., Sattarkhan St, Tehran

来源：

Journal of Ultrasound | 2017年 / 20卷 / 2期

关键词：

Cardiac tamponade; Cardiovascular; Diagnostic techniques; Diagnostic test approval; Pericardial effusion; Ultrasonography;

D O I：

10.1007/s40477-017-0246-5

中图分类号：

学科分类号：

摘要：

Introduction: Few studies have assessed the value and accuracy of focused cardiac ultrasound (FOCUS) performed by emergency physicians. The aim of the present study was to evaluate the diagnostic accuracy of FOCUS performed by emergency medicine residents compared to echocardiography performed by a cardiologist in emergency department (ED) patients suspected of cardiovascular disease. Methods: The research involved a prospective observational cross-sectional study enrolling patients over 18-years old suspected of having cardiovascular disease who required an echocardiograph. For each patient, a FOCUS test was conducted by a trained emergency medicine resident. The diagnostic accuracy of ED performed FOCUS was compared to echocardiography performed by a cardiologist (gold standard) in the ED. Sensitivity, specificity, positive and negative predictive values, and likelihood ratios were calculated for FOCUS. The agreement of EM residents and cardiologists on each finding was evaluated using Cohen’s kappa coefficient with 95% CI. Results: Two hundred and five patients, with a mean age of 61.0 ± 17 years (50% male), were included in this study. Agreement between FOCUS performed by an emergency medicine resident and echocardiography performed by a cardiologist in measuring ejection fraction of the left ventricle was 91% (κ = 0.85; 95% CI = 0.79–0.91). Reports of the two groups for identifying right ventricular enlargement showed 96% agreement (κ = 0.86; 95% CI = 0.82–0.90). The agreements for right ventricular pressure overload, wall motion abnormality and pericardial effusion were 100% (κ = 0.83; 95% CI = 0.77–0.89), 92% (κ = 0.83; 95% CI = 0.76–0.90), and 96% (κ = 0.83; 95% CI = 0.77–0.89), respectively. Conclusion: FOCUS performed by emergency medicine residents is comparable to echocardiography performed by cardiologists. Therefore, it could be a reliable tool and screening test for initial testing of patients suspected of cardiac abnormalities. © 2017, Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).

引用

页码：133 / 138

页数：5

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