Diagnostic Accuracy of Point-of-Care Ultrasound for Patients With Cardiogenic Shock - A Meta-Analysis and Systematic Review.

Abstract

Background: Cardiogenic shock, cardiac tamponade, and pulmonary embolism are critical conditions in cardiovascular emergencies, characterized by high mortality rates. Early diagnosis and treatment are essential to improve outcomes. Point-of-care ultrasound (POCUS) has emerged as a noninvasive tool for evaluating shock. However, further assessment through the latest meta-analyses is necessary to comprehensively evaluate its diagnostic accuracy in cardiogenic emergencies. Therefore, in this study, we conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of POCUS in patients with cardiogenic and obstructive shock.

Methods and results: Up to December 31, 2023, we systematically reviewed 9 studies reporting all 4 values (true positive, false positive, false negative, and true negative) published in the PubMed, Web of Science, and CENTRAL databases: 8 studies assessed cardiac shock, and 8 assessed obstructive shock separately. For cardiac shock, the pooled sensitivity was 86.1% (95% confidence interval [CI]: 71.5-93.9%), and specificity was 95.8% (95% CI: 94.0-97.2%). For obstructive shock, the pooled sensitivity was 77.5% (95% CI: 62.5-87.6%) and specificity was 97.6% (95% CI: 93.9-99.1%). The area under the curve was 0.96 (95% CI: 0.95-0.98) for cardiogenic shock and 0.94 (95% CI: 0.88-0.98) for obstructive shock.

Conclusions: This meta-analysis suggested that POCUS has reasonable diagnostic accuracy for cardiogenic and obstructive shock, particularly with high pooled specificity.