The Role of Ultrasound in Patients with Possible Penetrating Cardiac Wounds: A Prospective Multicenter Study
BACKGROUNDUltrasound is quickly becoming part of the trauma surgeon's practice, but its role in the patient with a penetrating truncal injury is not well defined. The purpose of this study was to evaluate the accuracy of emergency ultrasound as it was introduced into five Level I trauma centers...
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| Veröffentlicht in: | The Journal of Trauma: Injury, Infection, and Critical Care Infection, and Critical Care, 1999-04, Vol.46 (4), p.543-552 |
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| container_title | The Journal of Trauma: Injury, Infection, and Critical Care |
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| creator | Rozycki, Grace S. Feliciano, David V. Ochsner, M. Gage Knudson, M. Margaret Hoyt, David B. Davis, Frank Hammerman, David Figueredo, Vincent Harviel, J. Duncan Han, David C. Schmidt, Judith A. |
| description | BACKGROUNDUltrasound is quickly becoming part of the trauma surgeon's practice, but its role in the patient with a penetrating truncal injury is not well defined. The purpose of this study was to evaluate the accuracy of emergency ultrasound as it was introduced into five Level I trauma centers for the diagnosis of acute hemopericardium.
METHODSSurgeons or cardiologists (four centers) and technicians (one center) performed pericardial ultrasound examinations on patients with penetrating truncal wounds. By protocol, patients with positive examinations underwent immediate operation. Vital signs, base deficit, time from examination to operation, operative findings, treatment, and outcome were recorded.
RESULTSPericardial ultrasound examinations were performed in 261 patients. There were 225 (86.2%) true-negative, 29 (11.1%) true-positive, 0 false-negative, and 7 (2.7%) false-positive examinations, resulting in sensitivity of 100%, specificity of 96.9%, and accuracy of 97.3%. The mean time from ultrasound to operation was 12.1 +/- 5 minutes.
CONCLUSIONUltrasound should be the initial modality for the evaluation of patients with penetrating precordial wounds because it is accurate and rapid. |
| doi_str_mv | 10.1097/00005373-199904000-00002 |
| format | Article |
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METHODSSurgeons or cardiologists (four centers) and technicians (one center) performed pericardial ultrasound examinations on patients with penetrating truncal wounds. By protocol, patients with positive examinations underwent immediate operation. Vital signs, base deficit, time from examination to operation, operative findings, treatment, and outcome were recorded.
RESULTSPericardial ultrasound examinations were performed in 261 patients. There were 225 (86.2%) true-negative, 29 (11.1%) true-positive, 0 false-negative, and 7 (2.7%) false-positive examinations, resulting in sensitivity of 100%, specificity of 96.9%, and accuracy of 97.3%. The mean time from ultrasound to operation was 12.1 +/- 5 minutes.
CONCLUSIONUltrasound should be the initial modality for the evaluation of patients with penetrating precordial wounds because it is accurate and rapid.</description><identifier>ISSN: 0022-5282</identifier><identifier>EISSN: 1529-8809</identifier><identifier>DOI: 10.1097/00005373-199904000-00002</identifier><identifier>PMID: 10217216</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins, Inc</publisher><subject>Acute Disease ; Adolescent ; Adult ; Aged ; Algorithms ; Child ; Emergencies ; Female ; Heart Injuries - classification ; Heart Injuries - diagnostic imaging ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Pericardial Effusion - diagnostic imaging ; Predictive Value of Tests ; Prospective Studies ; Trauma Centers ; Ultrasonography ; United States ; Wounds, Penetrating - classification ; Wounds, Penetrating - diagnostic imaging</subject><ispartof>The Journal of Trauma: Injury, Infection, and Critical Care, 1999-04, Vol.46 (4), p.543-552</ispartof><rights>1999 Lippincott Williams & Wilkins, Inc.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3012-f4e122a18a3bc4bbfc49d52f4245c4bc646f2c2ff8cbd6dd6c640abad75222e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10217216$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rozycki, Grace S.</creatorcontrib><creatorcontrib>Feliciano, David V.</creatorcontrib><creatorcontrib>Ochsner, M. Gage</creatorcontrib><creatorcontrib>Knudson, M. Margaret</creatorcontrib><creatorcontrib>Hoyt, David B.</creatorcontrib><creatorcontrib>Davis, Frank</creatorcontrib><creatorcontrib>Hammerman, David</creatorcontrib><creatorcontrib>Figueredo, Vincent</creatorcontrib><creatorcontrib>Harviel, J. Duncan</creatorcontrib><creatorcontrib>Han, David C.</creatorcontrib><creatorcontrib>Schmidt, Judith A.</creatorcontrib><title>The Role of Ultrasound in Patients with Possible Penetrating Cardiac Wounds: A Prospective Multicenter Study</title><title>The Journal of Trauma: Injury, Infection, and Critical Care</title><addtitle>J Trauma</addtitle><description>BACKGROUNDUltrasound is quickly becoming part of the trauma surgeon's practice, but its role in the patient with a penetrating truncal injury is not well defined. The purpose of this study was to evaluate the accuracy of emergency ultrasound as it was introduced into five Level I trauma centers for the diagnosis of acute hemopericardium.
METHODSSurgeons or cardiologists (four centers) and technicians (one center) performed pericardial ultrasound examinations on patients with penetrating truncal wounds. By protocol, patients with positive examinations underwent immediate operation. Vital signs, base deficit, time from examination to operation, operative findings, treatment, and outcome were recorded.
RESULTSPericardial ultrasound examinations were performed in 261 patients. There were 225 (86.2%) true-negative, 29 (11.1%) true-positive, 0 false-negative, and 7 (2.7%) false-positive examinations, resulting in sensitivity of 100%, specificity of 96.9%, and accuracy of 97.3%. The mean time from ultrasound to operation was 12.1 +/- 5 minutes.
CONCLUSIONUltrasound should be the initial modality for the evaluation of patients with penetrating precordial wounds because it is accurate and rapid.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Algorithms</subject><subject>Child</subject><subject>Emergencies</subject><subject>Female</subject><subject>Heart Injuries - classification</subject><subject>Heart Injuries - diagnostic imaging</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pericardial Effusion - diagnostic imaging</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Trauma Centers</subject><subject>Ultrasonography</subject><subject>United States</subject><subject>Wounds, Penetrating - classification</subject><subject>Wounds, Penetrating - diagnostic imaging</subject><issn>0022-5282</issn><issn>1529-8809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kV9PHCEUxUljUzfWr9Dw1LexcOcvvpmNWhNNN62mj4SBS5fIzqzAuNlvL-PaxpfyQu7J75xLDoRQzs44E-03lk9dtmXBhRCsylMxS_CBLHgNoug6Jo7IIitQ1NDBMTmN0fUzUrcCuk_kmDPgLfBmQfz9GunP0SMdLX3wKag4ToOhbqArlRwOKdKdS2u6GueQzK1wwIwlN_yhSxWMU5r-nj3xnF7QVRjjFnVyz0jvJp-czhEY6K80mf1n8tEqH_H07T4hD1eX98vvxe2P65vlxW2hS8ahsBVyAMU7Vfa66nurK2FqsBVUdZ51UzUWNFjb6d40xjRZYapXpq0BAOvyhHw95G7D-DRhTHLjokbv1YDjFGUjWg5NKTLYHUCdnx0DWrkNbqPCXnIm57Ll37Llv7JfJcjWL287pn6D5p3xUG0GqgOwG31uID76aYdBrlH5tJb_-8TyBdIRiw4</recordid><startdate>199904</startdate><enddate>199904</enddate><creator>Rozycki, Grace S.</creator><creator>Feliciano, David V.</creator><creator>Ochsner, M. Gage</creator><creator>Knudson, M. Margaret</creator><creator>Hoyt, David B.</creator><creator>Davis, Frank</creator><creator>Hammerman, David</creator><creator>Figueredo, Vincent</creator><creator>Harviel, J. Duncan</creator><creator>Han, David C.</creator><creator>Schmidt, Judith A.</creator><general>Lippincott Williams & Wilkins, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199904</creationdate><title>The Role of Ultrasound in Patients with Possible Penetrating Cardiac Wounds: A Prospective Multicenter Study</title><author>Rozycki, Grace S. ; Feliciano, David V. ; Ochsner, M. Gage ; Knudson, M. Margaret ; Hoyt, David B. ; Davis, Frank ; Hammerman, David ; Figueredo, Vincent ; Harviel, J. Duncan ; Han, David C. ; Schmidt, Judith A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3012-f4e122a18a3bc4bbfc49d52f4245c4bc646f2c2ff8cbd6dd6c640abad75222e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Algorithms</topic><topic>Child</topic><topic>Emergencies</topic><topic>Female</topic><topic>Heart Injuries - classification</topic><topic>Heart Injuries - diagnostic imaging</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pericardial Effusion - diagnostic imaging</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Trauma Centers</topic><topic>Ultrasonography</topic><topic>United States</topic><topic>Wounds, Penetrating - classification</topic><topic>Wounds, Penetrating - diagnostic imaging</topic><toplevel>online_resources</toplevel><creatorcontrib>Rozycki, Grace S.</creatorcontrib><creatorcontrib>Feliciano, David V.</creatorcontrib><creatorcontrib>Ochsner, M. Gage</creatorcontrib><creatorcontrib>Knudson, M. Margaret</creatorcontrib><creatorcontrib>Hoyt, David B.</creatorcontrib><creatorcontrib>Davis, Frank</creatorcontrib><creatorcontrib>Hammerman, David</creatorcontrib><creatorcontrib>Figueredo, Vincent</creatorcontrib><creatorcontrib>Harviel, J. Duncan</creatorcontrib><creatorcontrib>Han, David C.</creatorcontrib><creatorcontrib>Schmidt, Judith A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of Trauma: Injury, Infection, and Critical Care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rozycki, Grace S.</au><au>Feliciano, David V.</au><au>Ochsner, M. Gage</au><au>Knudson, M. Margaret</au><au>Hoyt, David B.</au><au>Davis, Frank</au><au>Hammerman, David</au><au>Figueredo, Vincent</au><au>Harviel, J. Duncan</au><au>Han, David C.</au><au>Schmidt, Judith A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Role of Ultrasound in Patients with Possible Penetrating Cardiac Wounds: A Prospective Multicenter Study</atitle><jtitle>The Journal of Trauma: Injury, Infection, and Critical Care</jtitle><addtitle>J Trauma</addtitle><date>1999-04</date><risdate>1999</risdate><volume>46</volume><issue>4</issue><spage>543</spage><epage>552</epage><pages>543-552</pages><issn>0022-5282</issn><eissn>1529-8809</eissn><abstract>BACKGROUNDUltrasound is quickly becoming part of the trauma surgeon's practice, but its role in the patient with a penetrating truncal injury is not well defined. The purpose of this study was to evaluate the accuracy of emergency ultrasound as it was introduced into five Level I trauma centers for the diagnosis of acute hemopericardium.
METHODSSurgeons or cardiologists (four centers) and technicians (one center) performed pericardial ultrasound examinations on patients with penetrating truncal wounds. By protocol, patients with positive examinations underwent immediate operation. Vital signs, base deficit, time from examination to operation, operative findings, treatment, and outcome were recorded.
RESULTSPericardial ultrasound examinations were performed in 261 patients. There were 225 (86.2%) true-negative, 29 (11.1%) true-positive, 0 false-negative, and 7 (2.7%) false-positive examinations, resulting in sensitivity of 100%, specificity of 96.9%, and accuracy of 97.3%. The mean time from ultrasound to operation was 12.1 +/- 5 minutes.
CONCLUSIONUltrasound should be the initial modality for the evaluation of patients with penetrating precordial wounds because it is accurate and rapid.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>10217216</pmid><doi>10.1097/00005373-199904000-00002</doi><tpages>10</tpages></addata></record> |
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| subjects | Acute Disease Adolescent Adult Aged Algorithms Child Emergencies Female Heart Injuries - classification Heart Injuries - diagnostic imaging Humans Injury Severity Score Male Middle Aged Pericardial Effusion - diagnostic imaging Predictive Value of Tests Prospective Studies Trauma Centers Ultrasonography United States Wounds, Penetrating - classification Wounds, Penetrating - diagnostic imaging |
| title | The Role of Ultrasound in Patients with Possible Penetrating Cardiac Wounds: A Prospective Multicenter Study |
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