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Objective <p>This study aims to evaluate the impact of point-of-care ultrasound (PoCUS) and computed tomography (CT) on emergency department (ED) length of stay (LOS) and time to surgical consultation in patients with mild acute cholecystitis (AC).</p> Methods <p>Adult patients with CT-confirmed grade I AC were retrospectively enrolled and divided into the PoCUS-first group and the CT-first group. The primary outcome was the relationship between the door-to-ultrasound (US)/CT time and ED-LOS. The secondary outcome was the relationship between the door-to-US/CT time and time to surgical consultation.</p> Results <p>A total of 1627 patients were included with 264 in the PoCUS first group. In the PoCUS group, door-to-US time was positively associated with ED-LOS (β = 0.27, <i>p</i> &lt; 0.001) and time to surgical consultation (β = 0.36, <i>p</i> &lt; 0.001). Similarly, door-to-CT time was also positively associated with ED-LOS (β = 0.21, <i>p</i> &lt; 0.001) and time to surgical consultation (β = 0.75, <i>p</i> &lt; 0.001) in the CT group. Conducting PoCUS within 60&#xa0;min was associated with a reduced ED-LOS and time to surgical consultation, resulting in a saving of 22.4&#xa0;h and 266&#xa0;min, respectively. In the CT group, performing CT within 120&#xa0;min was associated with a reduced ED-LOS and time to surgical consultation, resulting in a decrease of 12&#xa0;h and 188&#xa0;min, respectively. The ED-LOS and time to surgical consultation were similar between patients receiving PoCUS within 60&#xa0;min in PoCUS group and those receiving CT within 120&#xa0;min in the CT group.</p> Conclusions <p>Performing PoCUS within 60&#xa0;min or CT within 120&#xa0;min was associated with shorter ED-LOS and earlier surgical consultation, enhancing the ED efficiency in patients with mild AC.</p> <p><i>Trial registration</i><b>:</b> NCT04149041 at ClinicalTrial.gov.</p>

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Impact of a POCUS-first versus CT-first approach on emergency department length of stay and time to surgical consultation in patients with acute cholecystitis: a retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月10日

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  • Chien-Tai Huang,
  • Liang-Wei Wang,
  • Shao-Yung Lin,
  • Tai-Yuan Chen,
  • Yi-Ju Ho,
  • Pei-Hsiu Wang,
  • Kao-Lang Liu,
  • Yao-Ming Wu,
  • Hsiu-Po Wang,
  • Wan-Ching Lien

摘要

Objective

This study aims to evaluate the impact of point-of-care ultrasound (PoCUS) and computed tomography (CT) on emergency department (ED) length of stay (LOS) and time to surgical consultation in patients with mild acute cholecystitis (AC).

Methods

Adult patients with CT-confirmed grade I AC were retrospectively enrolled and divided into the PoCUS-first group and the CT-first group. The primary outcome was the relationship between the door-to-ultrasound (US)/CT time and ED-LOS. The secondary outcome was the relationship between the door-to-US/CT time and time to surgical consultation.

Results

A total of 1627 patients were included with 264 in the PoCUS first group. In the PoCUS group, door-to-US time was positively associated with ED-LOS (β = 0.27, p < 0.001) and time to surgical consultation (β = 0.36, p < 0.001). Similarly, door-to-CT time was also positively associated with ED-LOS (β = 0.21, p < 0.001) and time to surgical consultation (β = 0.75, p < 0.001) in the CT group. Conducting PoCUS within 60 min was associated with a reduced ED-LOS and time to surgical consultation, resulting in a saving of 22.4 h and 266 min, respectively. In the CT group, performing CT within 120 min was associated with a reduced ED-LOS and time to surgical consultation, resulting in a decrease of 12 h and 188 min, respectively. The ED-LOS and time to surgical consultation were similar between patients receiving PoCUS within 60 min in PoCUS group and those receiving CT within 120 min in the CT group.

Conclusions

Performing PoCUS within 60 min or CT within 120 min was associated with shorter ED-LOS and earlier surgical consultation, enhancing the ED efficiency in patients with mild AC.

Trial registration: NCT04149041 at ClinicalTrial.gov.