title: Pelvic ultrasonography and length of stay in the ED: an observational study.
abstract: OBJECTIVE
  We compared emergency physician-performed pelvic ultrasonography (EPPU) with radiology department-performed pelvic ultrasonography (RPPU) in emergency department (ED) female patients requiring pelvic ultrasonography and their outcomes in relation to ED length of stay, ED readmission, and alternative diagnosis, within a 14-day follow-up period.
  
  
  METHODS
  This was a prospective, observational study of female patients of reproductive age who required either an EPPU or RPPU for their ED evaluation. We hypothesized that patients receiving EPPU would have a length of stay reduction greater than or equal to 60 minutes, as compared with RPPU. Statistical analyses included an independent-samples t test and multivariate regression modeling to control for factors associated with ED LOS.
  
  
  RESULTS
  Eighteen resident physicians performed EPPU, with 15 attending physicians supervising. Forty-eight patients received only EPPU, and 84 patients received only RPPU. In univariate analysis, those who received EPPU had an ED LOS 162 minutes less than those who received RPPU (95% confidence interval, 106-209 minutes). In multivariate analysis controlling for gynecologist consultation, disposition, and pregnancy status, patients who received EPPU had an ED LOS reduction of 108 minutes when compared with RPPU (95% confidence interval, 38-166 minutes). Five patients (10%) who had received EPPU and were discharged from the ED returned to the ED within 2 weeks, but none had alternative diagnoses.
  
  
  CONCLUSIONS
  Patients with EPPU had statistically and clinically significant reductions in ED LOS, even when controlling for disposition, gynecologist consultation in the ED, and pregnancy status. No patients in the study had an alternative diagnosis within 2 weeks of EPPU.
authors.affiliation: Department of Emergency Medicine, Olive View-University of California, Los Angeles Medical Center, Sylmar, CA. Electronic address: atchiem@gmail.com.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Chiem
authors.affiliation: Department of Emergency Medicine, University of California-Irvine Medical Center, Orange, CA.
authors.forename: Connie Hai-Yee
authors.initials: CH
authors.lastname: Chan
authors.affiliation: Department of Emergency Medicine, University of California-Irvine Medical Center, Orange, CA.
authors.forename: Deena Y
authors.initials: DY
authors.lastname: Ibrahim
authors.affiliation: Department of Emergency Medicine, University of California-Irvine Medical Center, Orange, CA.
authors.forename: Craig L
authors.initials: CL
authors.lastname: Anderson
authors.affiliation: University of California, Irvine, Orange, CA.
authors.forename: Daniel Sampson
authors.initials: DS
authors.lastname: Wu
authors.affiliation: University of California, Irvine, Orange, CA.
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Gilani
authors.affiliation: University of California, Irvine, Orange, CA.
authors.forename: Zulmy Jasmine
authors.initials: ZJ
authors.lastname: Mancia
authors.affiliation: Department of Emergency Medicine, University of California-Irvine Medical Center, Orange, CA.
authors.forename: John Christian
authors.initials: JC
authors.lastname: Fox
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D010388:Pelvis / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D014463:Ultrasonography