Pediatric Emergency Medicine Point-of-Care Ultrasound for the Diagnosis of Intussusception
| Autor: | Christopher S. Kennedy, Mary A. Hegenbarth, Lina Patel, Theodore E. Trigylidas, James C Kelly, Kevin O'Rourke |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Point-of-Care Systems Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Pediatric emergency medicine Predictive Value of Tests Intussusception (medical disorder) Medicine Humans Air enema Child Retrospective Studies Ultrasonography Splenic flexure business.industry Pediatric Emergency Medicine Point of care ultrasound Ultrasound Infant 030208 emergency & critical care medicine Retrospective cohort study medicine.disease Confidence interval Early Diagnosis 030220 oncology & carcinogenesis Child Preschool Emergency Medicine Female Radiology business Emergency Service Hospital Intussusception |
| Zdroj: | The Journal of emergency medicine. 57(3) |
| ISSN: | 0736-4679 |
| Popis: | Delayed diagnosis of intussusception can lead to air enema failure and increased morbidity. There are limited studies reporting the accuracy of pediatric emergency medicine (PEM) physician point-of-care ultrasound (POCUS) in diagnosing intussusception.The primary objective was to evaluate the accuracy of PEM POCUS in identifying ileocolic intussusception. The secondary objective was to identify factors associated with air enema failure.This was a retrospective study of children who underwent POCUS for suspected intussusception in a pediatric emergency department between January 2001 and December 2015. Patients were included if a pediatric radiologist confirmed the POCUS examination interpretation by image review, radiology department ultrasound, or air enema. Age, symptom duration, recurrent intussusception, and location of intussusception were examined as factors for air enema failure.One hundred and two POCUS examinations were completed on 101 patients who met the inclusion criteria. The mean age of patients was 22 months. Of 75 patients with intussusception, 72 were detected with POCUS. PEM POCUS had a sensitivity of 96.0% (95% confidence interval [CI] 91.6-100.0%), specificity of 92.6% (95% CI 82.7-100.0%), positive predictive value of 97.3% (95% CI 93.6-100.0%), and negative predictive value of 89.3% (95% CI 77.8-100.0%). Air enema failure was associated with intussusception distal to the splenic flexure (odds ratio = 10.00 [95% CI 2.81-35.61]; p 0.01) and age6 months (OR = 6.83 [95% CI 1.94-24.09]; p 0.01).PEM POCUS identifies intussusception with high sensitivity and specificity. Patients6 months old or with intussusception distal to the splenic flexure had a higher risk of air enema failure. |
| Databáze: | OpenAIRE |
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