Impact and appropriateness of the emergency ultrasonography in a tertiary care hospital

Objective: To quantify the notion of the impact of ultrasonography (US) on and the appropriateness of its use in, the diagnosis and treatment of emergency conditions. Material and Method: A prospective study was conducted between September 2006 and April 2007 at a tertiary care hospital. US was performed or supervised by experienced staff radiologists during the working hours and by final year radiology residents during the off-hours. Data collection forms were filled by radiology residents. The final discharge diagnoses were obtained from medical charts and computerized records. Data collected included age, gender, provisional diagnosis, ultrasound findings, the discharge diagnosis, time of ultrasound examination, other radiologic investigations and therapeutic interventions. Outcomes included the impact, appropriateness, and diagnostic accuracy of US. Results: Six hundred eighteen patients underwent 702 emergency ultrasound examinations. The median age was 51 years. Approximately 50% were male. The anatomical region most commonly examined was the abdomen (80%). US had an impact on clinical management in 85% of all examinations. Appropriate use of US was seen in 64% of all examinations. The overall accuracy of US was 90%. Factors associated with higher impact included suspected urological, vascular and musculoskeletal conditions, while vague abdominal conditions were associated with less impact. Conclusion: The impact of US on the management of emergency conditions was high and most requests for US were appropriate. However, a more efficient use of emergency US is still possible, especially for abdominal conditions.