Abstract:
OBJECTIVES:To investigate the current evidence on the use of point-of-care chest ultrasonography in older patients and geriatric settings and present the current state of the art of chest ultrasound applications. DESIGN:Special article based on a literature review with narrative analyses and expert clinical knowledge. SETTING AND PARTICIPANTS:All studies performed in a geriatric setting were included. Observational and intervention studies and meta-analyses including participants aged ≥70 years were also considered, even if not specifically focused on a geriatric setting. MEASURES:Data on participant characteristics, diagnostic accuracy of chest ultrasonography, and outcomes were collected for each considered study. Data were analyzed and discussed with a particular focus on the possible applications and advantages of chest ultrasonography in geriatric medicine, underlining the possible areas of future research. RESULTS:We found only 5 studies on the diagnostic accuracy and prognostic relevance of chest ultrasonography in geriatrics. However, several studies performed in emergency departments, intensive care units, and internal medicine wards included a large number of participants ≥70 years old; they suggest that chest ultrasonography may represent a valid aid to the diagnostics of acute dyspnea, pneumonia, acute heart failure, pneumothorax, and pleural diseases, with an accuracy in some cases superior to standard x-rays, especially when mobility limitation is present. Diaphragm ultrasonography may also represent a valid tool to guide mechanical ventilation weaning in older patients with acute respiratory failure. CONCLUSIONS AND IMPLICATIONS:Chest ultrasonography may represent a valid bedside diagnostic aid to the management of acute respiratory diseases in older patients. However, specific evidence is lacking for geriatric patients. Future research will need to focus on defining the reference standards and the diagnostic accuracy for older patients with frailty and multimorbidity, cost-efficacy and cost-effectiveness of the technique, its impact for clinical outcomes, and role for follow-up in the post-acute care.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Ticinesi A,Scarlata S,Nouvenne A,Lauretani F,Incalzi RA,Ungar A,GRETA (Gruppo di Ricerca sull’Ecografia Toracica nell’Anziano) Group of the Italian Society of Gerontology and Geriatrics (SIGG).doi
10.1016/j.jamda.2019.06.018subject
Has Abstractpub_date
2020-04-01 00:00:00pages
447-454.e6issue
4eissn
1525-8610issn
1538-9375pii
S1525-8610(19)30513-4journal_volume
21pub_type
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journal_title:Journal of the American Medical Directors Association
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journal_title:Journal of the American Medical Directors Association
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journal_title:Journal of the American Medical Directors Association
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doi:10.1016/j.jamda.2013.01.021
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abstract:BACKGROUND:Nursing home residents' repeated transfers to hospital are costly and can lead to in-hospital complications and high mortality for frail residents. However, no research has examined the trajectory of residents' symptoms over their nursing home residency and its relationship to hospital transfer. AIM:The pur...
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doi:10.1016/j.jamda.2016.06.019
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journal_title:Journal of the American Medical Directors Association
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
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更新日期:2016-12-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
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更新日期:2008-11-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
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doi:10.1016/j.jamda.2014.06.007
更新日期:2014-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jamda.2020.05.034
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
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journal_title:Journal of the American Medical Directors Association
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:
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journal_title:Journal of the American Medical Directors Association
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更新日期:2007-07-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2020-12-01 00:00:00
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更新日期:2004-11-01 00:00:00