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This study protocol aims to evaluate the impact of point-of-care ultrasound (POCUS) on the diagnosis and management of small bowel obstruction (SBO) in the emergency department (ED). SBO is a potentially life-threatening condition that requires prompt diagnosis and management. Currently, the diagnosis of SBO is based on clinical evaluation and imaging tests, including plain abdominal radiography and computed tomography (CT) scan. POCUS is a bedside imaging technique that is rapid, non-invasive, repeatable, cost-effective and radiation-free, and can provide valuable information for the diagnosis and management of SBO. The primary objective of this study is to compare the time to diagnosis of SBO between patients who undergo POCUS intestinal loops examination and those who do not undergo POCUS in the ED. The secondary objectives include comparing the hospital length of stay, the rate of surgical intervention, the rate of complications, and the mortality rate between the two groups. This is a monocentric retrospective cohort study that will include all adult patients (> 18 years old) who presented to the ED with suspected SBO. The study population will be divided into two groups: the POCUS group and the non-POCUS group. The sample size calculation will be based on the assumption of a 30% reduction in the time to diagnosis of SBO in the POCUS group compared to the non-POCUS group, with a power of 80%. The results of this study may provide more robust evidence on the diagnostic accuracy and impact of POCUS for SBO in the ED.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| The POCUS group | Patients who were evaluated by ED physicians who perform POCUS intestinal loops examination as part of their clinical practice | ||
| The non-POCUS group | Patients who were evaluated by ED physicians who do not perform POCUS intestinal loops examination for any reason |
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| Measure | Description | Time Frame |
|---|---|---|
| Time to diagnosis of SBO by POCUS or CT scan | The primary outcome will be the time to diagnosis of SBO by POCUS or CT scan, defined as the interval between the ED arrival and the confirmation of SBO by either imaging modality, comparing the two groups. | All patients will be seen by the emergency physician within 6 hours of admission to the emergency department. |
| Measure | Description | Time Frame |
|---|---|---|
| The hospital length of stay | The interval between the ED arrival and the hospital discharge | Patients will be followed up for a maximum of 2 months from admission to the emergency department, until discharge or death. |
| The rate of surgical intervention |
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Inclusion Criteria:
Exclusion Criteria:
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The study population will be divided into two groups:
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Carmine Cristiano Di Gioia | Contact | +39 3493812503 | cristianodigioia@icloud.com |
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The proportion of patients who underwent laparotomy or laparoscopy for SBO |
| Patients will be followed up for a maximum of 2 months from admission to the emergency department, until discharge or death. |
| The rate of complications | The proportion of patients who developed bowel ischemia, perforation, peritonitis or sepsis during their hospitalization | Patients will be followed up for a maximum of 2 months from admission to the emergency department, until discharge or death. |
| The mortality rate | The proportion of patients who died during their hospitalization or within 30 days after their ED arrival | Patients will be followed up for a maximum of 2 months from admission to the emergency department, until discharge or death. |