Abstract

LUNG ULTRASOUND IN DIAGNOSIS OF PNEUMONIA IN EMERGENCY DEPARTMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS

Ayman Ahmad Heikal, Yousef Mohammed Abozinadah, Turki Faiz Khawaji, Faisal Mohammed Altumaihi, hamed Marzoog Alharthi, Abdullah Saleh Alghamdi, Zead Ibrahim A. Alhussain, *Banan Ali Najmi, Zakaria Abdullah Alsaileek, Mohammad Tariq Almasri

Abstract

Background & Purpose: Acute community-acquired pneumonia needs to be identified early to keep away from most complications. The common diagnostic tools had been represented by means of blood exams and chest X- ray with CT test coming as a 2nd-line exploration. The presence of air in the pulmonary parenchyma has long been thought of as no longer explorable by ultrasound. The Aim of this work is to provide cumulative data about the diagnostic efficacy of Lung Ultrasound (LUS) in diagnosis of Community-acquired pneumonia (CAP) in emergency setting. Methods: A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify Emergency medicine RCTs, clinical trials, and comparative studies, which studied the Sensitivity and Specificity of LUS in pneumonia patients. A meta-analysis was done using fixed and random-effect methods. The primary outcome was Sensitivity for diagnostic odds ratio (DOR). Secondary outcome was Specificity for diagnostic odds ratio (DOR). The assessment of DOR was assessed by pooled Area under ROC curve for each parameter. Results: A total of 7 studies were identified involving 3380 patients. Regarding Sensitivity measure, the fixed- effects model of the meta-analysis study showed highly significant increase in pooled sensitivity (90%) of LUS in pneumonia patients (p < 0.01). Regarding Specificity measure, the fixed-effects model of the meta-analysis study showed highly significant increase in pooled specificity (92%) of LUS in pneumonia patients (p < 0.01). Conclusion: To conclude, the LUS proved to be a sufficiently useful and accurate tool to diagnose CAP in an adult population in the ED.

Keywords: Lung ultrasound, Diagnosis of Pneumonia, Emergency Department.