Focused assessment with sonography for trauma exam for diagnosis of pericardial effusion in penetrating thoracic trauma - A retrospective review from a level 1 trauma center.

Autor: De Mond J; Tulane University School of Medicine, Department of Trauma and Acute Care Surgery, New Orleans, LA, USA., Ghio M; Tulane University School of Medicine, Department of Trauma and Acute Care Surgery, New Orleans, LA, USA., Ritondale J; Tulane University School of Medicine, Department of Trauma and Acute Care Surgery, New Orleans, LA, USA., Butts C; Tulane University School of Medicine, Department of Trauma and Acute Care Surgery, New Orleans, LA, USA., McGrew P; Tulane University School of Medicine, Department of Trauma and Acute Care Surgery, New Orleans, LA, USA. Electronic address: pmcgrew@tulane.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Sep; Vol. 235, pp. 115788. Date of Electronic Publication: 2024 May 31.
DOI: 10.1016/j.amjsurg.2024.115788
Abstrakt: Introduction: Point of care ultrasound has long been used in the trauma setting for rapid assessment and diagnosis of critically ill patients. Its utility for diagnosis of pericardial effusion in the setting of penetrating thoracic trauma has more recently been a topic of consideration, given the rapid decompensation that these patients can experience.
Objectives: This study aims to identify the diagnostic accuracy of point of care ultrasound in the diagnosis of pericardial effusion among patients with penetrating thoracic trauma.
Methods: Retrospective review of 2099 patients brought to the trauma bay between the years 2016 and 2021 were analyzed for diagnosis of pericardial effusion. Patients who were diagnosed with a pericardial effusion were investigated for point of care ultrasound findings. Descriptive statistics were performed to identify sensitivity, specificity, positive predictive value, and negative predictive value.
Results: Prevalence was calculated to be 26.7 cases of pericardial effusion per 1000 patients presenting with penetrating thoracic trauma. Incidence was estimated to be 3.8 cases of pericardial effusion per 1000 person-years. Calculation of diagnostic capabilities of ED POCUS revealed a sensitivity of 96.36 ​%, a specificity of 100 ​%, PPV of 100 ​%, and NPV of 99.90 ​%.
Conclusions: Point of Care cardiac ultrasonography is a reliable tool for the rapid diagnosis of pericardial effusion in penetrating thoracic trauma patients. Patients with ultrasound suggestive of this condition should receive rapid surgical management to prevent decompensation.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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