Contribution of Bedside Ultrasound (POCUS) on acute heart failure management in hospitalized geriatric patients: a prospective study

Methods: A prospective randomized trial was conducted from October 26, 2022, to September 15, 2023, involving 101 patients randomized into two groups: the interventional group received POCUS (pulmonary and inferior vena cava imaging) in addition to standard care, while the control group received standard care alone. The primary objective was to compare mortality rates between the two groups and to assess the influence of ultrasound parameters on mortality. Secondary objectives included comparing lengths of stay and readmission rates. Results: No significant differences in mortality were observed between the groups (p =0,5). However, specific ultrasound characteristics, such as a dilated and non-collapsible inferior vena cava, as well as reduced collapsibility at onset of symptoms and discharge were associated with increased mortality (respectively p=0.01, p=0.02 and p=0.01). No significant differences in length of stay or readmission rates were noted. Conclusions: Although the addition of POCUS to usual care did not reduce overall mortality, it provided valuable additional information for prognosis. Further studies are necessary to determine how to optimize its use and to enhance the management of this vulnerable population.