Enhancing rapid diagnosis of pulmonary embolism in the emergency department: the critical role of point-of-care ultrasound (POCUS)—a systematic review and meta-analysis

Abstract Background Point-of-care ultrasound (POCUS), performed at the patient’s bedside, has been widely used to diagnose several medical conditions. However, its accuracy in diagnosing pulmonary embolism (PE) in the emergency department (ED) is not fully established. Therefore, the current meta-an...

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Main Authors: Hany A. Zaki, Benny Ponappan, Eman E. Shaban, Ahmed Shaban, Amira Shaban, Ahmed Khan, Kaleem Basharat, Mohammed F. Abosamak
Format: Article
Language:English
Published: SpringerOpen 2025-03-01
Series:The Egyptian Journal of Radiology and Nuclear Medicine
Subjects:
Online Access:https://doi.org/10.1186/s43055-025-01453-w
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author Hany A. Zaki
Benny Ponappan
Eman E. Shaban
Ahmed Shaban
Amira Shaban
Ahmed Khan
Kaleem Basharat
Mohammed F. Abosamak
author_facet Hany A. Zaki
Benny Ponappan
Eman E. Shaban
Ahmed Shaban
Amira Shaban
Ahmed Khan
Kaleem Basharat
Mohammed F. Abosamak
author_sort Hany A. Zaki
collection DOAJ
description Abstract Background Point-of-care ultrasound (POCUS), performed at the patient’s bedside, has been widely used to diagnose several medical conditions. However, its accuracy in diagnosing pulmonary embolism (PE) in the emergency department (ED) is not fully established. Therefore, the current meta-analysis examined the accuracy of POCUS in diagnosing PE in the ED. Results A total of fourteen studies involving 1835 patients suspected of PE were included. The pooled results showed that lung ultrasound has a sensitivity and specificity of 47% and 88%, respectively. The most frequently used clinical sign for diagnosing PE using lung ultrasound was the presence of at least one hypoechoic pleural-based lesion. The pooled results also showed that deep venous ultrasound, which mostly used the bilateral compression of the femoral and popliteal veins, yielded a sensitivity of 56% and a specificity of 96% for PE. In addition, cardiac ultrasound yielded a sensitivity of 39% and specificity of 94% for PE, with the most frequently used clinical sign being right ventricular (RV) dilation. On the other hand, multiorgan POCUS displayed a sensitivity of 79% and specificity of 79%. Conclusion Cardiac, lung, and deep venous ultrasounds have consistently shown high specificity, making them valuable diagnostic tools for ruling in PE at the patient’s bedside. On the other hand, multiorgan POCUS displayed high diagnostic accuracy, making it a valuable tool for confirming or dismissing PE in ED.
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spelling doaj-art-8da8f0f790bf427eb6c2b28e7a5f49312025-08-20T02:49:26ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622025-03-0156111710.1186/s43055-025-01453-wEnhancing rapid diagnosis of pulmonary embolism in the emergency department: the critical role of point-of-care ultrasound (POCUS)—a systematic review and meta-analysisHany A. Zaki0Benny Ponappan1Eman E. Shaban2Ahmed Shaban3Amira Shaban4Ahmed Khan5Kaleem Basharat6Mohammed F. Abosamak7College of Medicine, Qatar University, Department of Emergency MedicineMOHMOHMinistry of Health and PopulationMinistry of Health and PopulationHamad Medical CorporationHamad Medical Corporation, Department of Emergency MedicineDepartment of Anesthesia and Intensive Care Medicine, Faculty of Medicine, Tanta UniversityAbstract Background Point-of-care ultrasound (POCUS), performed at the patient’s bedside, has been widely used to diagnose several medical conditions. However, its accuracy in diagnosing pulmonary embolism (PE) in the emergency department (ED) is not fully established. Therefore, the current meta-analysis examined the accuracy of POCUS in diagnosing PE in the ED. Results A total of fourteen studies involving 1835 patients suspected of PE were included. The pooled results showed that lung ultrasound has a sensitivity and specificity of 47% and 88%, respectively. The most frequently used clinical sign for diagnosing PE using lung ultrasound was the presence of at least one hypoechoic pleural-based lesion. The pooled results also showed that deep venous ultrasound, which mostly used the bilateral compression of the femoral and popliteal veins, yielded a sensitivity of 56% and a specificity of 96% for PE. In addition, cardiac ultrasound yielded a sensitivity of 39% and specificity of 94% for PE, with the most frequently used clinical sign being right ventricular (RV) dilation. On the other hand, multiorgan POCUS displayed a sensitivity of 79% and specificity of 79%. Conclusion Cardiac, lung, and deep venous ultrasounds have consistently shown high specificity, making them valuable diagnostic tools for ruling in PE at the patient’s bedside. On the other hand, multiorgan POCUS displayed high diagnostic accuracy, making it a valuable tool for confirming or dismissing PE in ED.https://doi.org/10.1186/s43055-025-01453-wPulmonary embolismPoint-of-care ultrasoundEmergency departmentLung ultrasoundDeep venous ultrasoundCardiac ultrasound
spellingShingle Hany A. Zaki
Benny Ponappan
Eman E. Shaban
Ahmed Shaban
Amira Shaban
Ahmed Khan
Kaleem Basharat
Mohammed F. Abosamak
Enhancing rapid diagnosis of pulmonary embolism in the emergency department: the critical role of point-of-care ultrasound (POCUS)—a systematic review and meta-analysis
The Egyptian Journal of Radiology and Nuclear Medicine
Pulmonary embolism
Point-of-care ultrasound
Emergency department
Lung ultrasound
Deep venous ultrasound
Cardiac ultrasound
title Enhancing rapid diagnosis of pulmonary embolism in the emergency department: the critical role of point-of-care ultrasound (POCUS)—a systematic review and meta-analysis
title_full Enhancing rapid diagnosis of pulmonary embolism in the emergency department: the critical role of point-of-care ultrasound (POCUS)—a systematic review and meta-analysis
title_fullStr Enhancing rapid diagnosis of pulmonary embolism in the emergency department: the critical role of point-of-care ultrasound (POCUS)—a systematic review and meta-analysis
title_full_unstemmed Enhancing rapid diagnosis of pulmonary embolism in the emergency department: the critical role of point-of-care ultrasound (POCUS)—a systematic review and meta-analysis
title_short Enhancing rapid diagnosis of pulmonary embolism in the emergency department: the critical role of point-of-care ultrasound (POCUS)—a systematic review and meta-analysis
title_sort enhancing rapid diagnosis of pulmonary embolism in the emergency department the critical role of point of care ultrasound pocus a systematic review and meta analysis
topic Pulmonary embolism
Point-of-care ultrasound
Emergency department
Lung ultrasound
Deep venous ultrasound
Cardiac ultrasound
url https://doi.org/10.1186/s43055-025-01453-w
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