Enhanced FoCUS in Patients With Shortness of Breath

Study Overview
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Brief Summary
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Retrospective observational study performed in a internal medicine ward of a French university hospital. Included patients were hospitalized for acute shortness of breath who have benefited from a eFOCUS which was defined as a focused cardiac Ultrasound with utilization of Doppler measurements. The objectives were the therapeutic and diagnosis changes induced by eFoCUS. The primary endpoint was defined by the pooled introduction or discontinuation of diuretics, antibiotics or anticoagulants associated with eFoCUS results.

Detailed Description
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It was a retrospective observational study performed in a internal medicine ward of a French University Hospital. Patients were identified in the hospital database, pertinent features and eFoCUS findings were extracted and anonymized. Inclusion criteria: Adult patients admitted to an internal medicine ward from the ED for acute shortness of breath. Realization of an eFoCUS prescribed by the physician in charge of the patient Exclusion criteria: • Comprehensive echocardiography already performed Methods For each identified patient, pertinent data (demography, initial diagnosis and treatment (diuretics, antibiotics, anticoagulants)) and eFoCUS findings were extracted from the hospital files, anonymized and entered in a LibreOffice spreadsheet. Extracted diagnosis were gathered into the following categories: Community-acquired pneumonia (CAP), Acute cardiogenic pulmonary edema (ACPE), Pulmonary embolism (PE), Chronic Obstructive Pulmonary Disease (COPD) and other (OTHER). Objectives and endpoints The main objective was the therapeutic change induced by eFoCUS. The primary endpoint was defined by the pooled introduction or discontinuation of diuretics, antibiotics or anticoagulants associated with eFoCUS results. The secondary objectives were diagnosis modifications induced by eFoCUS. Data analysis Numerical data were presented as mean ± SD or as median with interquartile range depending on the normality. The paired Student's t-test was used to compare normally distributed data. The chi-square test was used for the comparison of noncontinuous variables expressed as proportions. A p-value <0.05 was considered significant. All p-values were two-sided. Statistical analysis was realized with R (4.03.3) in the Rstudio® environment.

Official Title
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Impact of an Enhanced Focused Cardiac Ultrasound on Treatment Modifications in a Population of Internal Medicine Patients: Retrospective Study

Conditions
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Shortness of Breath, Acute Respiratory Failure

Intervention / Treatment
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* Diagnostic Test: Diagnostic test


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients admitted to a internal medicine ward from the ED for acute shortness of breath. Realization of an eFoCUS prescribed by the physician in charge of the patient Exclusion Criteria: Comprehensive echocardiography already performed

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients<br>Patients hospitalized for shortness of breath with realization of an enhanced FoCUS | Diagnostic Test: Diagnostic test<br>* Cardiac Ultrasound in order to explore the causes of shortness of breath<br>* Other names: Focused cardiac Ultrasound;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pooled introduction or discontinuation of diuretics, antibiotics or anticoagulants | Number of patients for whom there was an introduction or discontinuation of diuretics, antibiotics or anticoagulants associated with Focused cardiac ultrasound | up to 24 hours after eFoCUS | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes of diagnostic categories associated with eFOCUS | Number of patients for whom the diagnostic category (pneumonia, acute cardiac failure, pulmonary embolism, COPD, other) was modified after Focused cardiac ultrasound | up to 24 hours after eFoCUS | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute decompensated heart failure, Pneumonia, Pulmonary Embolism, Ultrasound