Sarah Pujol1, Jeremy Laurent2, Thibaut Markarian3, Pierre-Géraud Claret4, Jean Yves Lefrant5, Claire Roger6, Laurent Muller7, Jean Emmanuel de La Coussaye8, Antonia Perez-Martin9, Xavier Bobbia10. 1. Department of Anesthesiology, Emergency and Critical Care Medicine, Intensive Care Unit, Nîmes University Hospital, place du Pr Debré, 30029 Nîmes, France. Electronic address: s.pujol1986@gmail.com. 2. Department of Vascular Medicine and Laboratory, CHU de Nîmes, hôpital Caremeau, place du Pr-Debré, 30029 Nîmes cedex 9, France. Electronic address: jeremy.laurent@hotmail.fr. 3. Emergency Department, Timone 2 Hospital, Aix-Marseille University, Marseille, France. Electronic address: Thibaut.MARKARIAN@ap-hm.fr. 4. Department of Anesthesiology, Emergency and Critical Care Medicine, Intensive Care Unit, Nîmes University Hospital, place du Pr Debré, 30029 Nîmes, France. Electronic address: pierre.geraud.claret@gmail.com. 5. Department of Anesthesiology, Emergency and Critical Care Medicine, Intensive Care Unit, Nîmes University Hospital, place du Pr Debré, 30029 Nîmes, France. Electronic address: jean.yves.lefrant@chu-nimes.fr. 6. Department of Anesthesiology, Emergency and Critical Care Medicine, Intensive Care Unit, Nîmes University Hospital, place du Pr Debré, 30029 Nîmes, France. Electronic address: clairepenetrat@hotmail.com. 7. Department of Anesthesiology, Emergency and Critical Care Medicine, Intensive Care Unit, Nîmes University Hospital, place du Pr Debré, 30029 Nîmes, France. Electronic address: laurent.muller@chu-nimes.fr. 8. Department of Anesthesiology, Emergency and Critical Care Medicine, Intensive Care Unit, Nîmes University Hospital, place du Pr Debré, 30029 Nîmes, France. Electronic address: jean.emmanuel.delacoussaye@chu-nimes.fr. 9. Department of Vascular Medicine and Laboratory, CHU de Nîmes, hôpital Caremeau, place du Pr-Debré, 30029 Nîmes cedex 9, France. Electronic address: antonia.perez.martin@chu-nimes.fr. 10. Department of Anesthesiology, Emergency and Critical Care Medicine, Intensive Care Unit, Nîmes University Hospital, place du Pr Debré, 30029 Nîmes, France; Emergency Department, Timone 2 Hospital, Aix-Marseille University, Marseille, France. Electronic address: xavier.bobbia@gmail.com.
Abstract
INTRODUCTION: Compression ultrasonography (CUS) is a validated technique for the diagnosis of deep venous thrombosis (DVT), but has never been studied with pocket-sized ultrasound device (PUD). The main objective of this study was to assess the diagnostic performance of CUS made by emergency physicians (EPs) using a PUD. MATERIALS: This was a prospective, diagnostic test assessment, single-center study. Patients underwent VCU performed by a trained EP with PUD (CUS-PUD) for searching proximal DVT (PDVT) and were then seen by an expert vascular physician who blindly performed a duplex venous ultrasound, which was the criterion standard. CUS-PUD's diagnostic performance was evaluated by sensitivity (Se), specificity (Sp), and positive and negative predictive values (PPV and NPV). RESULTS: The sample included 57 patients of whom 56 were analyzed. Eleven (20%) PDVT were diagnosed with CUS-PUD: 7 (64%) femoral and 4 (36%) popliteal. The CUS-PUD's Se was 100% [72%; 100%], Sp 100% [92%; 100%]. The PPV was 100% [74%; 100%], and the NPV was 100% [90%; 100%]. CONCLUSION: CUS-PUD performed with a pocket-sized ultrasound appears to be feasible in emergency practice for the diagnosis of proximal DVT. A study with a larger sample size will have to describe the accuracy.
INTRODUCTION: Compression ultrasonography (CUS) is a validated technique for the diagnosis of deep venous thrombosis (DVT), but has never been studied with pocket-sized ultrasound device (PUD). The main objective of this study was to assess the diagnostic performance of CUS made by emergency physicians (EPs) using a PUD. MATERIALS: This was a prospective, diagnostic test assessment, single-center study. Patients underwent VCU performed by a trained EP with PUD (CUS-PUD) for searching proximal DVT (PDVT) and were then seen by an expert vascular physician who blindly performed a duplex venous ultrasound, which was the criterion standard. CUS-PUD's diagnostic performance was evaluated by sensitivity (Se), specificity (Sp), and positive and negative predictive values (PPV and NPV). RESULTS: The sample included 57 patients of whom 56 were analyzed. Eleven (20%) PDVT were diagnosed with CUS-PUD: 7 (64%) femoral and 4 (36%) popliteal. The CUS-PUD's Se was 100% [72%; 100%], Sp 100% [92%; 100%]. The PPV was 100% [74%; 100%], and the NPV was 100% [90%; 100%]. CONCLUSION: CUS-PUD performed with a pocket-sized ultrasound appears to be feasible in emergency practice for the diagnosis of proximal DVT. A study with a larger sample size will have to describe the accuracy.
Authors: Adrienne N Malik; Jonathan Rowland; Brian D Haber; Stephanie Thom; Bradley Jackson; Bryce Volk; Robert R Ehrman Journal: Curr Emerg Hosp Med Rep Date: 2021-05-11