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Role of surgeon-performed ultrasound on further management of patients with acute abdominal pain: a randomised controlled clinical trial
  1. A Lindelius1,2,
  2. S Törngren1,2,
  3. H Pettersson1,
  4. J Adami3
  1. 1
    Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
  2. 2
    Section of Surgery, Stockholm South General Hospital, Stockholm, Sweden
  3. 3
    Karolinska Institutet, Department of Medicine, Clinical Epidemiology Unit, Stockholm, Sweden
  1. Dr A Lindelius, Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Section of Surgery, Stockholm South General Hospital, Sjukhusbacken 10, 118 83 Stockholm, Sweden; anna.lindelius{at}sodersjukhuset.se

Abstract

Background: The use of bedside ultrasound performed by the surgeon or emergency physician on duty at the emergency department is increasing. A study was performed which is the first randomised study to evaluate the benefits of surgeon-performed ultrasound for the management of the acute abdomen.

Methods: 800 patients who attended the emergency department at Stockholm South General Hospital, Sweden for abdominal pain were randomised either to receive or not receive surgeon-performed ultrasound as a complement to routine management. Outcome measures included the number of complementary investigations, time spent in the emergency department, admission rate, length of hospital stay if admitted, admission to surgery and timing of surgery if required.

Results: The number of complementary ultrasound examinations was considerably higher in the group who did not receive bedside ultrasound (18.8 percentage points difference, p<0.001). The admission rate was lower in the ultrasound group (7.2 percentage points difference, p = 0.041) and the proportion of patients requiring surgery submitted for surgery directly from the emergency department was higher in the ultrasound group (18.5 percentage points difference, p = 0.013).

Conclusion: This study shows benefits in the management of the acute abdomen resulting in fewer further requested examinations, fewer admissions and shorter lead times to surgery. On the basis of these results, it is recommended for implementation in emergency departments.

Trial registration number: NCT00550511.

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Footnotes

  • Funding: The study was conducted with funding from the County Council of Stockholm.

  • Competing interests: None.

  • Ethics approval: The patients received oral and written information from the study surgeon and were included after informed consent. The study was approved by the Institutional Review Board at Karolinska Institutet, Stockholm, Sweden.

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