POCUS Screening for TAA in Hypertensive Patients in the ED

The Chinese University of Hong Kong

Status: Not yet enrolling

Conditions: Thoracic Aortic Aneurysm (TAA); Aortic Dissection

Treatments: Diagnostic Test: Point-of-care ultrasound

Study type: Observational

Funder types: Other

Identifiers

NCT06854588

NTEC-2024-753

Details and patient eligibility

About

The investigators are going to recruit hypertensive patients in the emergency department of Prince of Wales Hospital. Point-of-care ultrasound of the aorta and measurements of the aortic diameter will be obtained. Other relevant clinical data will also be obtained for analysis. The primary outcome is the number of patients with a maximum aortic diameter of ≥ 4.5 cm and/or ≥ 50% localized enlarged diameter relative to the adjacent normal segment as indicated by POCUS.

Full description

Investigators trained with point-of-care ultrasound (POCUS) will recruit hypertensive patients in the emergency department (ED) of Prince of Wales Hospital. POCUS will be performed using a handheld ultrasound device to visualise the aortic root, ascending aorta, aortic arch and descending aorta. Measurements of the diameter will be obtained from different segments of the thoracic aorta for analysis. The definition of aortic aneurysm is a maximum aortic diameter of ≥ 4.5 cm and/or ≥ 50% localized enlarged diameter relative to the adjacent normal segment as indicated by POCUS. The primary outcome is the prevalence of thoracic aortic aneurysm (TAA) in hypertensive patients in the ED. The secondary outcomes include the number of patients with confirmed TAA as verified by CTA, BMI for all participants, the number of CTA scans conducted for TAA confirmation, the number of surgical interventions performed among TAA patients, the ICU admission rate, ICU length of stay, hospital length of stay and mortality, proportion of adequate visualisation of POCUS studies obtained, agreement of aortic diameter measurement between CTA and POCUS, and signs and symptoms of TAA patients presenting to the ED. In addition, the investigators will assess the 28-day all-cause mortality and any advanced imaging done outside the ED.

Enrollment: 1,483 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Adult patients aged ≥ 18 years attending the ED during the study period
• Known history of hypertension or newly diagnosed hypertension in the ED

Exclusion criteria

• Known history of aortic aneurysm or dissection
• Previous thoracic aortic interventions or endovascular stenting
• Patients in cardiopulmonary resuscitation
• Traumatic patients
• Patients refuse to participate the study

Trial design

1,483 participants in 1 patient group

hypertensive patients presenting to the emergency department

Description:

1. Adult patients aged ≥ 18 years attending the ED during the study period 2. Known history of hypertension or newly diagnosed hypertension in the ED

Treatment:

Diagnostic Test: Point-of-care ultrasound