Jg. Ouslander et al., USE OF A PORTABLE ULTRASOUND DEVICE TO MEASURE POST-VOID RESIDUAL VOLUME AMONG INCONTINENT NURSING-HOME RESIDENTS, Journal of the American Geriatrics Society, 42(11), 1994, pp. 1189-1192
OBJECTIVE: To determine the accuracy of a portable ultrasound device f
or the assessment of post-void residual (PVR) volume among incontinent
nursing home (NH) residents. DESIGN: Prospective, clinical series. SE
TTING: Seven community-based nursing homes. STUDY POPULATION: Two hund
red one consecutively assessed incontinent NH residents who were parti
cipating in a larger clinical trial. MEASUREMENTS: PVR volumes measure
d by trained research associates using a portable ultrasound device an
d by in-and-out catheterization were compared. The accuracy of the ult
rasound was calculated using the volume obtained by catheterization as
the gold standard. RESULTS: The ultrasound demonstrated excellent tes
t-retest and interrater reliability. For low PVRs, the device was high
ly sensitive (.90 for PVR <50 mL and .95 for PVR <100 mL) and moderate
ly specific (.71 for PVR <50 mL and .63 for PVR < 100 mL). For PVRs of
more than 200 mL (n = 26), the ultrasound had a sensitivity of .69 an
d a specificity of .99. CONCLUSION: The portable ultrasound we used wa
s reliable and reasonably accurate for assessing PVR in a representati
ve sample of incontinent NH residents. Because the sensitivity for cli
nically significant urinary retention (PVR >200 mL) was only .69, repe
ated measurements may be necessary to exclude high PVR in individual N
H residents. Recent changes in ultrasound design should improve its ea
se of use and accuracy. Although measuring PVR by ultrasound is much e
asier and more comfortable than catheterization for both NH residents
and staff, the cost of the device may be a barrier to its widespread u
se in the NH setting.