Point of Care Ultrasound, Small Bowel Obstruction
Conditions
Keywords
POCUS, SBO
Brief summary
This study protocol aims to evaluate the impact of point-of-care ultrasound (POCUS) on the diagnosis and management of small bowel obstruction (SBO) in the emergency department (ED). SBO is a potentially life-threatening condition that requires prompt diagnosis and management. Currently, the diagnosis of SBO is based on clinical evaluation and imaging tests, including plain abdominal radiography and computed tomography (CT) scan. POCUS is a bedside imaging technique that is rapid, non-invasive, repeatable, cost-effective and radiation-free, and can provide valuable information for the diagnosis and management of SBO. The primary objective of this study is to compare the time to diagnosis of SBO between patients who undergo POCUS intestinal loops examination and those who do not undergo POCUS in the ED. The secondary objectives include comparing the hospital length of stay, the rate of surgical intervention, the rate of complications, and the mortality rate between the two groups. This is a monocentric retrospective cohort study that will include all adult patients (\> 18 years old) who presented to the ED with suspected SBO. The study population will be divided into two groups: the POCUS group and the non-POCUS group. The sample size calculation will be based on the assumption of a 30% reduction in the time to diagnosis of SBO in the POCUS group compared to the non-POCUS group, with a power of 80%. The results of this study may provide more robust evidence on the diagnostic accuracy and impact of POCUS for SBO in the ED.
Interventions
None listed
Sponsors
Azienda Ospedaliero-Universitaria di Modena
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age \> 18 years old * Clinical suspicion of SBO based on history and physical examination * Plain abdominal radiography (AXR) or CT scan performed in the ED
Exclusion criteria
* Pregnancy * Known bowel obstruction * Previous abdominal surgery within 30 days * Refusal or inability to consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to diagnosis of SBO by POCUS or CT scan | All patients will be seen by the emergency physician within 6 hours of admission to the emergency department. | The primary outcome will be the time to diagnosis of SBO by POCUS or CT scan, defined as the interval between the ED arrival and the confirmation of SBO by either imaging modality, comparing the two groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The hospital length of stay | Patients will be followed up for a maximum of 2 months from admission to the emergency department, until discharge or death. | The interval between the ED arrival and the hospital discharge |
| The rate of surgical intervention | Patients will be followed up for a maximum of 2 months from admission to the emergency department, until discharge or death. | The proportion of patients who underwent laparotomy or laparoscopy for SBO |
| The rate of complications | Patients will be followed up for a maximum of 2 months from admission to the emergency department, until discharge or death. | The proportion of patients who developed bowel ischemia, perforation, peritonitis or sepsis during their hospitalization |
| The mortality rate | Patients will be followed up for a maximum of 2 months from admission to the emergency department, until discharge or death. | The proportion of patients who died during their hospitalization or within 30 days after their ED arrival |
Contacts
Primary ContactCarmine Cristiano Di Gioia
Outcome results
None listed