title: Ultrasonography in patients without trauma in the emergency department: impact on discharge diagnosis.
abstract: OBJECTIVE
  The aim of this study was to examine to what extent findings on ultrasonography performed in the emergency department (ED) after hours confirm or alter the referral diagnosis in patients without trauma as reflected in the discharge diagnosis.
  
  
  METHODS
  In this prospective study, data from 136 ultrasonographic examinations performed in patients without trauma after hours in the ED during January and February 2002 were evaluated against the suspected preimaging diagnosis of the referring ED physician and the actual discharge diagnosis from the ED or after hospitalization. The rate of preimaging and postimaging concordance was statistically analyzed and compared by calculation of confidence intervals and by the McNemar test.
  
  
  RESULTS
  Normal ultrasonographic findings were documented in 54 patients (40%), and pathologic findings were documented in 82 (60%). Thirty-four (25%) of the 136 examinations were concordant with the initial referring physician's diagnosis. Of the 102 studies that were not concordant with the initial referral suspected diagnoses, that is, being either a study with normal findings or offering an alternative diagnosis, 81 (79.4%) were concordant with the discharge diagnosis.
  
  
  CONCLUSIONS
  After-hours ultrasonographic findings in patients without trauma seen in the ED seem to have a high impact on the discharge diagnosis and are concordant with it in more than 80% of cases.
authors.affiliation: Department of Diagnostic Radiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel. yoels1@gmail.com
authors.forename: Yoel
authors.initials: Y
authors.lastname: Siegel
authors.forename: Ahuva
authors.initials: A
authors.lastname: Grubstein
authors.forename: Vladislav
authors.initials: V
authors.lastname: Postnikov
authors.forename: Osnat
authors.initials: O
authors.lastname: Moreh
authors.forename: Ethan
authors.initials: E
authors.lastname: Yussim
authors.forename: Maya
authors.initials: M
authors.lastname: Cohen
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000592:standards / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies; D012017:Referral and Consultation / Q000592:standards / Q000706:statistics & numerical data*; D014463:Ultrasonography / Q000592:standards / Q000706:statistics & numerical data*