But a new study of hand-carried echocardiography found that in one large teaching hospital, at least, it doesn't help most patients get discharged any faster.
In a randomized trial, Dr. Brian Lucas of Rush Medical College, Chicago, and colleagues assigned 226 general medicine inpatients to care guided by hand-carried echocardiography and 227 similar patients to usual care.
The mean hospital stay was 46.1 hours in the intervention group and 46.9 hours in the usual care group. The difference was not statistically significant; "nor is it clinically meaningful," the researchers said in a June 10 online paper in the American Journal of Medicine.
In a post hoc analysis, however, care guided by hand-carried echocardiography reduced length of stay by 17% for patients referred for heart failure. In contrast, those with other indications had a 20% increase.
Among participants who underwent both hand-carried and standard echocardiography, say the investigators, hospitalists changed management due to hand-carried echocardiography in 37%.
"Real-time comparisons of hospitalists' hand-carried results and standard echocardiography results were importantly inadequate or mistaken in only 6% and 12% of patients, respectively," Dr. Lucas told Reuters Health by email. "Whether or not these percentages are low enough to safely change the timing of hospital discharge will require further study."
Overall, there is no evidence of its value in the general population, he and his colleagues say. They believe future studies should focus on subgroups most likely to benefit from hand-carried echocardiography, and "patients with heart failure may be one such group."
By David Douglas
Am J Med 2011.
Last Updated: 2011-06-24 17:07:25 -0400 (Reuters Health)