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. 2023 Dec;56(8):647-652.
doi: 10.1007/s00391-022-02144-1. Epub 2022 Dec 7.

[Geriatric ultrasound : Prospective evaluation of ultrasound as extended screening in acute geriatric patients]

[Article in German]
W Weinrebe  1 , S Kreppenhofer  2 , C F Dietrich  3
Affiliations

[Geriatric ultrasound : Prospective evaluation of ultrasound as extended screening in acute geriatric patients]

[Article in German]
W Weinrebe et al. Z Gerontol Geriatr. 2023 Dec.

Erratum in

  • Erratum zu: Geriatrischer Ultraschall.
    Weinrebe W, Kreppenhofer S, Dietrich CF. Weinrebe W, et al. Z Gerontol Geriatr. 2023 Dec;56(8):653. doi: 10.1007/s00391-022-02157-w. Z Gerontol Geriatr. 2023. PMID: 36662243 German. No abstract available.

Abstract
in English, German

Background: The aim of this study was to evaluate ultrasound as a routinely used procedure and extended physical examination in geriatric patients in acute care.

Methods: Prospective study of 86 patients using ultrasound as a screening examination (abdomen, basal sections of the thorax, thyroid glands) under comparative use of a hand-held ultrasound device (HHUSD) and a high-end ultrasound (HEUS = gold standard).

Results: In 20/86 (23.2%) clinically relevant findings with therapeutic consequences were found (pleural effusion, urinary retention, choledocholithiasis metatases, colon tumor). In 22/86 (25.6%) patients, additional questions existed besides the screening indication: tumor search (9.3%), anemia (5.8%), liver value elevation (5.8%), dyspnea (5.8%), splenic pathologies (2.3%), weight loss (1.2%), infectious focus (1.2%), diarrhea (1.2%), intra-abdominal hematoma (1.1%), abdominal aortic aneurysm (1.2%). The most common sonographic findings included: cholecystolithiasis (32.6%); right pleural effusion (31.4%), thyroid nodules (30.2%), renal cysts (27.9%), and fatty liver (26.7%). There were significant differences in sizing between HHUSD and HEUS (kidneys, pancreatic corpus and pancreatic caudal diameters, portal vein, left hepatic vein) without diagnostic relevance.

Conclusion: The extended screening by ultrasound provided important answers to classical questions in geriatrics (e.g. urinary retention, volume deficiency/pleural effusion) in many cases. The new findings had therapeutic consequences in one fifth of the patients. The HHUSD can be used in screening.

Zusammenfassung: HINTERGRUND: Ziel der Studie war die Evaluierung der Sonographie als routinemäßig eingesetztes Verfahren und erweiterte körperliche Untersuchung bei geriatrischen Patienten in der Akutversorgung.

Methoden: Prospektive Studie mit 86 Patienten mit der Sonographie als Screeninguntersuchung (Abdomen, basale Abschnitte des Thorax, Schilddrüse) unter vergleichender Verwendung von „hand-held ultrasound device“ (HHUSD) und einem „high-end ultrasound“ (HEUS = Goldstandard).

Ergebnisse: Bei 20/86 (23,2 %) wurden klinisch relevante Befunde mit therapeutischer Konsequenz gefunden (Pleuraerguss, Harnverhalt, Choledocholithiasis, Metastasen, Kolontumor). Bei 22/86 (25,6 %) Patienten bestanden neben der Screeningindikation zusätzliche Fragestellungen: Tumorsuche (9,3 %), Anämie (5,8 %), Leberwerterhöhung (5,8 %), Dyspnoe (5,8 %), Milzpathologien (2,3 %), Gewichtsverlust (1,2 %), Infektfokus (1,2 %), Durchfall (1,2 %), intraabdominales Hämatom (1,1 %), Bauchaortenaneurysma (1,2 %). Die häufigsten sonographischen Befunde waren: Cholezystolithiasis (32,6 %), rechtsseitiger Pleuraerguss (31,4 %), Schilddrüsenknoten (30,2 %), Nierenzysten (27,9 %) und Fettleber (26,7 %). Es gibt signifikante Unterschiede in der Größenbestimmung zwischen HHUSD und HEUS (Nieren, Pankreaskorpus- und Pankreasschwanzdurchmesser, V. portae, V. hepatica dextra) ohne diagnostische Relevanz.

Schlussfolgerung: Das erweitere Screening mittels Ultraschall lieferte in den vielen Fällen eine wichtige Antwort auf klassische Fragestellungen in der Geriatrie (z. B. Harnverhalt, Volumenmangel/Pleuraerguss). Die neuen erhobenen Befunde hatten bei einem Fünftel der Patienten therapeutische Konsequenzen. Das HHUSD kann in der Screeningfunktion eingesetzt werden.

Keywords: Acute geriatric patients; Clinically relevant findings; Extended admission screening; Standardized ultrasound examination; Ultrasound in geriatric patients.

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