A Point-of-Care Ultrasound-Driven Diagnostic Pathway for Emergency Department Patients with Dyspnea: A Randomized Controlled Trial

Stig Holm Ovesen*, Søren Helbo Skaarup, Rasmus Aagaard, Nikolaj Raaber, Gitte Boier Tygesen, Thomas Nielsen, Charlotte Møgelvang, Jesper Wamberg, Peter Biesenbach, Christina Brandhof, Danny Yu, Jakob Grønnebæk Rhode, Christian Linde Larsen, Kas Zarandi, Christina Katrin Lehmann, Søren Majgaard Pedersen, Mads Damgaard Mørkenborg, Ronja Leth, Simon Thorgaard-Rasmussen, Philip UhdBo Løfgren, Stefan Posth, Michael Dan Arvig, Bo Martin Bibby, Christian B Laursen, Hans Kirkegaard, Jesper Weile

*Corresponding author af dette arbejde

Abstract

BACKGROUND: Previous trials have suggested that point-of-care ultrasound for emergency department (ED) patients with dyspnea increases the proportion of patients discharged within 24 h. We aimed to assess whether this effect could be confirmed.

METHODS: This trial was a randomized controlled trial in ten Danish EDs. Adult patients presenting to the ED with dyspnea as the chief complaint were randomized to the addition or omission of focused lung and cardiac ultrasound. The primary outcome was the proportion of patients discharged alive within 24 h. Secondary outcomes included overall hospital length of stay, chest imaging utilization, and 72 h alive and revisit-free.

RESULTS: Among 674 patients who were randomized between January 25, 2023, and August 23, 2024, 663 were included in the analysis. The primary outcome occurred in 141 (42.6%) of 331 patients in the intervention group versus 151 (45.5%) of 332 in the control group (risk difference: -2.9; 95% confidence interval: -10.4-4.7; p=0.45). The overall incidence rate of hospital discharges per person-days at risk was 0.28 in the intervention group versus 0.32 in the control group (hazard ratio: 0.93; 95% confidence interval: 0.79-1.08; p=0.35).

CONCLUSIONS: In adult ED patients with dyspnea as chief complaint, a point-of-care ultrasound-driven diagnostic pathway did not alter the proportion of patients discharged alive within 24 h or the overall hospital length of stay compared with standard care.

OriginalsprogEngelsk
BogserieEuropean Respiratory Journal. Supplement
ISSN0904-1850
DOI
StatusE-pub ahead of print - 18 dec. 2025

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