Diagnostic value of combined heart and lung ultrasound in emergency department patients with dyspnea

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2025-04-17 DOI:10.1111/cpf.70009

Anna Bjällmark, Gustaf Hummel, Kambiz Shahgaldi

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Abstract

Background

Acute dyspnea in emergency departments (ED) requires prompt and accurate diagnosis due to its high mortality and readmission rates. Conventional diagnostic methods are resource-intensive and time-consuming. This study aimed to evaluate the diagnostic accuracy and time to diagnosis of combined heart and lung ultrasound (HeaLus) compared to standard emergency department evaluation in patients presenting with dyspnea.

Methods

A prospective study was conducted in a cohort of 61 patients at the ED of Danderyd Hospital, Sweden. HeaLus examinations were performed alongside routine investigations. Diagnostic performance of HeaLus and ED evaluation was assessed for accuracy, sensitivity, specificity, positive predictive value, and negative predictive value, and agreement using Kappa index. Median time to diagnostics was compared between HeaLus and ED evaluation using Mann-Whitney U-test.

Results

Heart failure was the most common diagnosis (20%) among patients presenting with dyspnea. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 95% (95% CI: [87%, 98%]), 98% (95% CI: [88%, 100%]), 90% (95% CI: [69%, 97%]), 95% (95% CI: [85%, 99%]), and 94% (95% CI: [74%, 99%]), respectively. The agreement between HeaLus and ED diagnoses was 0.88. Time to diagnosis was significantly reduced with HeaLus (21 min vs. 3 h and 28 min).

Conclusions

HeaLus offers rapid and accurate assessment of dyspnea. These results suggest that HeaLus could be valuable in optimizing patient management, particularly in settings with limited resources and long ED wait times.

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心肺联合超声对急诊科呼吸困难患者的诊断价值

背景急诊急性呼吸困难由于其高死亡率和再入院率需要及时准确的诊断。传统的诊断方法需要大量的资源和时间。本研究旨在评价心肺联合超声（HeaLus）诊断呼吸困难患者的准确性和诊断时间，并与标准急诊科评估进行比较。方法对瑞典Danderyd医院急诊科的61例患者进行前瞻性研究。在常规检查的同时进行健康检查。采用Kappa指数评估HeaLus和ED诊断的准确性、敏感性、特异性、阳性预测值和阴性预测值以及一致性。采用Mann-Whitney u检验比较HeaLus和ED评估的中位诊断时间。结果在出现呼吸困难的患者中，心衰是最常见的诊断（20%）。诊断准确性、敏感性、特异性、阳性预测值和阴性预测值分别为95% （95% CI:[87%, 98%]）、98% （95% CI:[88%, 100%]）、90% （95% CI:[69%, 97%]）、95% （95% CI:[85%, 99%]）和94% （95% CI:[74%, 99%]）。HeaLus诊断与ED诊断的一致性为0.88。HeaLus显著缩短了诊断时间（21分钟vs. 3小时和28分钟）。结论HeaLus能快速准确地评估呼吸困难。这些结果表明HeaLus在优化患者管理方面很有价值，特别是在资源有限和急诊科等待时间长的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.