Utility of Point-of-Care Ultrasound (PoCUS) in Intermediate and Long-Term Care Geriatric Settings.

OBJECTIVES

To assess the utility of point-of-care ultrasound (PoCUS) in the clinical evaluation of older adults within intermediate and long-term care (LTC) settings.

DESIGN

Retrospective cross-sectional, single-center study.

SETTING AND

PARTICIPANTS

Individuals aged 65 years or older who underwent PoCUS during the study period (March 1, 2022-March 31, 2025) within an intermediate care center and its affiliated LTC units.

METHODS

A geriatrician trained in multiorgan PoCUS performed the ultrasounds at the request of the attending physicians, all of whom were directly involved in the patient's care at a post-acute and long-term care (PALTC) facility. Each case followed an individualized PoCUS protocol based on specific clinical questions to be answered. Clinical, functional, frailty, and ultrasound data were collected from medical records for analysis.

RESULTS

Among 2563 individuals treated at PALTC, 315 PoCUS scans were conducted on 244 patients (mean age, 86 ± 8.6 years). Most exams (62%) were done in the subacute unit, with 19% performed in LTC and 14% in the functional recovery unit. PoCUS was mainly used to support physical examinations (23%); its findings confirmed clinical suspicion in about one-third of cases, ruled clinical suspicion out in another third, led to new and unsuspected diagnoses in a quarter of patients, and was used for follow-ups or guided procedures in the rest. PoCUS led to treatment changes in 56% of cases, avoided 47 (17%) unnecessary transfers to the emergency department, and avoided the performance of 35 (11%) of invasive procedures. Attending physicians indicated a reduction in clinical uncertainty in 96% of cases.

CONCLUSIONS AND IMPLICATIONS: PoCUS supports the clinical assessment and management of older adults in PALTC settings, potentially improving clinical decision-making, identifying new pathologies, guiding treatment, promoting safer procedures, and reducing unnecessary referrals and interventions. However, effective use and feasibility depend on adequate training and education.