Does Point-of-Care Ultrasound Affect Outcomes in Pediatric Patients with Skin and Soft Tissue Infections?
| Autor: | Ashlyn Shields, Christopher M. Pruitt, Nipam Shah, Jonathan Buice |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Affect (psychology) 01 natural sciences law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Incision and drainage medicine Humans Prospective Studies 030212 general & internal medicine Skin Diseases Infectious 0101 mathematics Child Prospective cohort study Abscess Ultrasonography business.industry Soft Tissue Infections 010102 general mathematics Infant Soft tissue General Medicine Emergency department medicine.disease Anti-Bacterial Agents Hospitalization Treatment Outcome Point-of-Care Testing Child Preschool Cellulitis Female Emergency Service Hospital business |
| Zdroj: | Southern Medical Journal. 113:645-650 |
| ISSN: | 1541-8243 0038-4348 |
| Popis: | Objective There is increasing evidence for the use of point-of-care ultrasound (POCUS) in pediatric patients with skin and soft tissue infections (SSTI), but there is a lack of sufficient data on its impact on SSTI outcomes. The objective of this study was to determine whether POCUS use is associated with fewer complications after discharge from the pediatric emergency department. Methods This was a prospective cohort study in patients presenting to the emergency department with SSTI between the ages of 2 months and 19 years old. Adverse outcomes included hospitalization after discharge, change in antibiotics, subsequent procedures, or reevaluation by a medical professional. Outcome information was obtained 1 week later. Descriptive statistics and χ2 tests were used. Results Of 456 patients screened, 250 were enrolled. POCUS was performed on 113 (45%) patients. The median age was 5 years, with more females in the non-POCUS group compared with the POCUS group (58% vs. 52%). Cellulitis without abscess was more commonly diagnosed in the POCUS group than in the non-POCUS group (26% vs 14%, P = 0.02.) The patients in the non-POCUS group were more likely to undergo incision and drainage than those in the POCUS group (62% vs 45%, P = 0.008). Overall, a greater number of patients in the POCUS group did not undergo any procedure (45% vs 27%, P = 0.003). The outcomes at 1 week did not differ significantly between the two groups. Conclusions POCUS use may lead to fewer procedures, but it does not lead to significantly better outcomes. Large randomized controlled trials are needed to confirm or refute our findings. |
| Databáze: | OpenAIRE |
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