Point-of-care ultrasound is an accurate, time-saving, and cost-effective modality for surveillance imaging of vesicoureteral reflux
Christian Morrill, BS, Martine Madill, BA, Omar Ayyash, MD, Marc Colaco, MD, Glenn Cannon, MD, Janelle Fox, MD, Francis Schneck, MD, Rajeev Chaudhry, MD.
Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
BACKGROUND: Vesicoureteral reflux (VUR) is a common pediatric condition with an estimated incidence of 1% in the general population. For patients with reflux AUA guidelines recommend ultrasound (US) every 12 months to monitor renal growth and parenchymal scarring. However, adding a complete retroperitoneal ultrasound (CRUS) adds significant cost and time to the office visit. As an alternative point of care ultrasound (POCUS) can instead be performed during the office visit with a reduced increase in cost and time. We hypothesize that POCUS is a timesaving and cost-effective alternative to CRUS for monitoring of VUR with similar diagnostic outcomes.
METHODS: We performed a single-institution retrospective analysis for all patients undergoing renal US as part of their follow up of VUR over a 12-month period. Patients were stratified based on the methodology of their US. Cohorts were then analyzed for the outcomes, demographics, cost, and time.
RESULTS: A total of 99 patients were included in this analysis, with 52 having POCUS and the remaining 47 having CRUS. There was no significant difference in age, gender, or severity of VUR between cohorts. Patients that underwent CRUS had a mean increase in hospital visit time of 152 min (SD 68 min). Standard charge of a CRUS was $1716.00 whereas the standard charge of POCUS was $273.00. Thus, if those 47 patients that underwent CRUS had instead undergone POCUS it would correspond to $67,821 less total charges to payers. There was no significant difference in the rate of new findings between modalities (13.5% for POCUS versus 23.4% for CRUS, p=0.3).
CONCLUSIONS: VUR is a common condition and monitoring requires regular ultrasounds. POCUS can be easily performed by a urologist during an office visit. Doing so leads to decreased cost and time without sacrificing diagnostic quality.
Back to 2021 Posters