J Acute Care Surg.  2021 Mar;11(1):22-29. 10.17479/jacs.2021.1.22.

Usefulness of Echocardiography for General Surgery Patients on Intensive Care Units: When and How?

• Chung JH
• Kim N

• KMID: 2514225
• DOI: http://doi.org/10.17479/jacs.2021.1.22

Abstract

Purpose
Echocardiography is useful in the management of critically ill patients, but there are few studies on the usefulness of an echocardiography for critical general surgery patients. This study aimed to address this by analyzing the indications and findings for and clinical outcomes between (1) chest trauma; (2) cardiac specific pathology; and (3) hemodynamic instability groups of critical general surgery patients

Methods
Retrospective analysis was performed on the medical records data from the last 5 years of general surgery patients who were admitted to the intensive care unit (ICU) and had an echocardiography at least once during their ICU stay. The patient data were divided into 3 groups according to the indication for an echocardiography and based on the clinical situation. Demographics, the ratio of positive echocardiography findings, and clinical outcomes including the length of hospital stay, length of ICU stay, and in-hospital mortality were analyzed among these groups.

Results
There were statistical differences in the rate of positive echocardiography findings (p = 0.018) and in-hospital mortality (p = 0.001) amongst the groups with different echocardiography indications; there was no difference in the length of stay. Patients who had an echocardiography due to hemodynamic instability or cardiologic pathology presented with a higher ratio of positive echocardiography findings and mortality, compared with the chest trauma patient group. The chest trauma group showed the lowest rate of positive echocardiography findings (7%).

Conclusion
Echocardiographies are useful for general surgery patients in ICUs when there are indications such as previous cardiac pathology history or hemodynamic instability.

Keyword

echocardiography; intensive care unit; general surgery