Archives of Academic Emergency Medicine最新文献

{"title":"Prevalence of Delirium and Its Related Factors in Burn Patients; a Systematic Review and Meta-Analysis.","authors":"Hamidreza Alizadeh Otaghvar, Ramyar Farzan, Parham Tamimi, Aliasghar Ghaderi, Masoomeh Najafi, Mobina Tohidian, Fatemeh Izadi, Seyed Amirhossein Mazhari","doi":"10.22037/aaem.v12i1.2136","DOIUrl":"10.22037/aaem.v12i1.2136","url":null,"abstract":"<p><strong>Introduction: </strong>Considering the importance of delirium disorder in burn patients and its complications, the present systematic review and meta-analysis aimed to determine the prevalence of delirium and its related factors in burn patients.</p><p><strong>Methods: </strong>A comprehensive, systematic search was performed in different international electronic databases, such as Scopus, PubMed, and Web of Science, as well as Persian electronic databases such as Iranmedex, and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as \"Prevalence\", \"Delirium\", and \"Burns\" from the earliest to the 17th of July, 2023.</p><p><strong>Results: </strong>In total, 2,710 burn patients participated in ten original studies. Among the participants, 64.6% were male. In the ten studies, the reported pooled prevalence of delirium among burn patients was 20.5% (95% CI: 10.9% to 35.0%; I²=96.889%; P<0.001). Also, factors such as total body surface area, duration of hospitalization, mortality, days on ventilator, alcoholism, benzodiazepine dose, methadone dose, age, male gender, ICU days, operation days, wound care under anesthesia, and opioid dose had a significant correlation with the prevalence of delirium in burn patients.</p><p><strong>Conclusion: </strong>Health managers and policymakers can reduce the prevalence of delirium in burn patients by eliminating or reducing factors associated with it.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e7"},"PeriodicalIF":5.4,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Triage from the Viewpoint of Psychiatric Emergency Department Nurses; a Qualitative Study.","authors":"Fatemeh Rajab Dizavandi, Razieh Froutan, Hossein Karimi Moonaghi, Abbas Ebadi, Mohammad Reza Fayyazi Bordbar","doi":"10.22037/aaem.v11i1.2080","DOIUrl":"https://doi.org/10.22037/aaem.v11i1.2080","url":null,"abstract":"<p><strong>Introduction: </strong>Mental health triage is a new nursing practice concept that is less studied and defined, especially among Iranian nurses. Therefore, this study aimed to explain the concept of mental health triage from the perspective of psychiatric emergency department (ED) nurses.</p><p><strong>Methods: </strong>This qualitative study collected data using semi-structured interviews with psychiatric ED nurses. Sampling was purposive and continued until data saturation. Analysis was conducted using conventional content analysis, as described in Griesheim and Landman approach.</p><p><strong>Results: </strong>15 psychiatric ED nurses with the mean age of 35.13 ± 8.44 years were interviewed (60% male). Finally, two themes, five categories, and 16 sub-categories emerged from data analysis. Two themes emerged, including mental health triage meaning and mental health triage structure. The former included two categories of the nature and characteristics of mental health triage, and the latter consisted of three categories of mental state exploration from surface to depth, safety control measures, and the degree of emergency. According to the \"degree of emergency\" category, nurses could not make triage decisions based on their perceptions in an acceptable way.</p><p><strong>Conclusion: </strong>Psychiatric ED nurses have an appropriate understanding of mental health triage meaning. However, according to these nurses, its structure is associated with shortcomings that limit the provision of mental health triage services and reduce their quality.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"11 1","pages":"e70"},"PeriodicalIF":5.4,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Outcomes of Patient Transport to the Hospital by Emergency Medical Services (EMS); a Cross-sectional Study.","authors":"Pariwat Phungoen, Lap Woon Cheung, Kamonwon Ienghong, Korakot Apiratwarakul","doi":"10.22037/aaem.v11i1.2112","DOIUrl":"https://doi.org/10.22037/aaem.v11i1.2112","url":null,"abstract":"<p><strong>Introduction: </strong>To enhance the efficiency, it is essential to understand the patterns of service users and develop policies that facilitate effective personnel and resource management. This study aimed to compare the characteristic and outcomes of patients who were transferred to emergency department (ED) by emergency medical services (EMS) and patients transported by other means.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was conducted at Srinagarind Hospital, Thailand, over a 5-year period from 2017-2021. The baseline characteristics, treatment modalities, and outcomes of patients who were transported to ED using EMS and Non-EMS were gathered and compared using STATA software.</p><p><strong>Results: </strong>The study included 15,501 patients with the median age of 51 (interquartile range (IQR): 23-71) years who were referred by EMS over the five-year period (51.72% male). EMS patients had significantly higher median age (51 (23 - 71) vs. 37 (21 - 60); p < 0.001) with male preference (p < 0.001). In the EMS group, the triage level 1 (need for resuscitation) was higher than the non-EMS group (p < 0.001), most of the patients referred following trauma (p < 0.001), and the frequency of cardiac arrest was considerably higher than non-EMS group (2.54% vs 0.05%; p < 0.001). Patients in the EMS group received a higher number of blood tests (p < 0.001), plain radiographic exams (p < 0.001), computerized tomography (CT) scans (p < 0.001), and complex procedures (p < 0.001) than the non-EMS group. The EMS group had a greater number of hospital admissions (p < 0.001) and intensive care unit (ICU) admissions (p < 0.001) compared to the non-EMS group. The EMS group exhibited a significantly higher mortality rate compared to the non-EMS group (p < 0.001).</p><p><strong>Conclusion: </strong>The population utilizing EMS services had higher median age, higher frequency of emergency cases and trauma related complaint, higher need for treatment interventions and imaging procedures, higher rate of hospital and ICU admissions, as well as higher rate of mortality compared to the non-EMS group.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"11 1","pages":"e69"},"PeriodicalIF":5.4,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Pain Scales in Predicting Critical Diagnoses in Non-Traumatic Abdominal Pain Cases; a Cross-sectional Study.","authors":"Supapilai Ueareekul, Chanon Changratanakorn, Parinya Tianwibool, Nattikarn Meelarp, Wachira Wongtanasarasin","doi":"10.22037/aaem.v11i1.2131","DOIUrl":"https://doi.org/10.22037/aaem.v11i1.2131","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate assessment and management of abdominal pain in the emergency department (ED) is crucial, as it can indicate potentially life-threatening conditions requiring timely treatment. This study aimed to evaluate the ability of pain scales to predict critical diagnoses in patients with non-traumatic abdominal pain.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at a tertiary university hospital and involved individuals aged 15 years and above who presented to the ED with non-traumatic abdominal pain. Pain severity was evaluated using subjective pain scales, including the Numerical Rating Scale (NRS) and the Face Pain Scale (FPS), as well as objective pain scales, including the Critical Care Pain Observation Tool (CPOT) and the Non-verbal Pain Score (NVPS). The area under the receiver operating characteristic curve (AuROC) was employed to determine the discriminative ability of each pain scale to predict critical diagnosis.</p><p><strong>Results: </strong>264 cases with the mean age of 47.2±19.4 years were studied (53.0% male). The most common location of abdominal pain was epigastric pain (43.9%). Most patients presented with dull-aching pain, and those with critical diagnoses had more of this characteristic than those with non-critical diagnoses. (52.5% vs. 28.3%, p = 0.01). The overall median NRS, FPS, CPOT, and NVPS of included participants were 8 (interquartile range (IQR) 7-10), 8 (IQR 6-8), 3 (IQR 1-4), and 3 (IQR 2-4), respectively. Patients with critical diagnoses had a higher NVPS score than patients with non-critical diagnoses (median score of 4 vs. 3, p = 0.02). The AuROC of NRS, FPS, CPOT, and NVPS were 0.53 (95% CI: 0.45-0.62), 0.55 (95% CI: 0.46-0.63), 0.59 (95% CI: 0.50-0.68), and 0.62 (95% CI: 0.53-0.71), respectively. The correlation coefficients among these scales were considered moderately correlated or higher.</p><p><strong>Conclusion: </strong>In evaluating patients with non-traumatic abdominal pain, the NVPS demonstrated the highest accuracy in predicting critical diagnoses. However, all pain scales, whether subjective or objective, exhibited suboptimal performance in predicting critical diagnoses.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"11 1","pages":"e68"},"PeriodicalIF":5.4,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognition of Stroke in the Emergency Room (ROSIER) Scale in Identifying Strokes and Transient Ischemic Attacks (TIAs); a Systematic Review and Meta-Analysis.","authors":"Iman Chehregani Rad,&nbsp;Amir Azimi","doi":"10.22037/aaem.v11i1.2135","DOIUrl":"10.22037/aaem.v11i1.2135","url":null,"abstract":"<p><strong>Introduction: </strong>A range of screening tools has been developed to assist emergency healthcare providers in rapidly and accurately diagnosing strokes. In this study, we investigated the diagnostic value of the Recognition of Stroke in the Emergency Room (ROSIER) scale in identifying individuals with stroke and transient ischemic attack (TIA).</p><p><strong>Methods: </strong>We conducted a systematic search across online databases of PubMed, Embase, Scopus, and Web of Science until June 12th, 2023, aiming to identify studies that assessed the diagnostic performance of the ROSIER scale in detecting strokes and TIAs among individuals with suspected stroke symptoms.</p><p><strong>Results: </strong>Data extracted from 34 studies were analyzed, demonstrating that the ROSIER score, with a cut-off value of ≥ 1, has sensitivity of 0.89 (95% confidence interval (CI): 0.86-0.92), specificity of 0.76 (95% CI: 0.69-0.81), diagnostic odds ratio (DOR) of 25.41 (95% CI: 17.2-37.54), and area under the curve (AUC) of 0.91 (95% CI: 0.85-0.90) in detection of strokes and TIAs. Meta-regression subgroup analysis revealed variations in sensitivity and specificity based on different settings and assessors. Sensitivity was higher in pre-hospital settings when the test was administered by emergency medical services (EMS) and emergency department (ED) paramedic staff, whereas specificity was higher in emergency department settings and when physicians and neurologists conducted the test.</p><p><strong>Conclusion: </strong>A moderate level of evidence shows that the ROSIER scale is considered an excellent tool for identifying strokes and TIAs. As a valid method for identifying strokes, it holds applicability across diverse settings and can be effectively used by assessors with different specialties.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"11 1","pages":"e67"},"PeriodicalIF":5.4,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/74/aaem-11-e67.PMC10568950.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41231921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NEXUS vs. Canadian C-Spine Rule (CCR) in Predicting Cervical Spine Injuries; a Systematic Review and Meta-analysis.","authors":"Alireza Baratloo,&nbsp;Koohyar Ahmadzadeh,&nbsp;Mohammad Mehdi Forouzanfar,&nbsp;Mahmoud Yousefifard,&nbsp;Mehri Farhang Ranjbar,&nbsp;Behrooz Hashemi,&nbsp;Seyed Hadi Aghili","doi":"10.22037/aaem.v11i1.2143","DOIUrl":"10.22037/aaem.v11i1.2143","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical decision tools have been shown to reduce imaging rates for clearance of suspected cervical spine injury (CSI). This review provides more comprehensive evidence on the diagnostic capabilities of National Emergency X-Radiography Utilization Study (NEXUS) and Canadian C-spine rule (CCR) in this regard.</p><p><strong>Method: </strong>A systematic review of the current literature was performed on studies published until Jan 26^th, 2023, in databases of Medline, Scopus, Web of Science, and Embase, investigating the performance of NEXUS and CCR in blunt trauma patients. QUADAS-2 and GRADE guidelines were used to assess the quality and certainty of evidence. All analyses were performed using the STATA 14.0 statistical analysis software.</p><p><strong>Results: </strong>35 articles comprising 70000 patients for NEXUS and 33000 patients for CCR were included in this review. NEXUS and CCR were evaluated to have a sensitivity of 0.94 (95% confidence interval (CI): 0.88 to 0.98) and 1.00 (95% CI: 0.98 to 1.00) in the detection of any CSI and 0.95 (95% CI: 0.89 to 0.98) and 1.00 (95% CI: 0.95 to 1.00) in the detection of clinically important CSI. The area under the curve (AUC) of NEXUS and CCR was 0.85 and 0.97 for any CSI and 0.78 (95% CI: 0.74 to 0.81) and 0.94 (95% CI: 0.91 to 0.96) for clinically important CSI.</p><p><strong>Conclusion: </strong>Our study demonstrates that both NEXUS and CCR can be used in ruling out patients with low risk of CSI, and CCR was shown to have superior performance. Even though these tools have low specificity, their application can still greatly reduce the number of radiographic imaging performed in emergency departments.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"11 1","pages":"e66"},"PeriodicalIF":5.4,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0c/0c/aaem-11-e66.PMC10568954.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41231905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal Foreign Body Missed Diagnosis; an Analysis of 12 Cases.","authors":"Xin Yan,&nbsp;Guoping Dai","doi":"10.22037/aaem.v11i1.2102","DOIUrl":"10.22037/aaem.v11i1.2102","url":null,"abstract":"<p><p>Missed diagnosis of foreign bodies in esophagus occasionally results in adverse consequences for patients. This study aimed to analyze the clinical characteristics of esophageal foreign body missed diagnosis in 12 cases. Among the 12 patients, 7 didn't undergo esophagus-related examination due to mild pain; One case didn't report a clear history of swallowing foreign bodies. For one case, computed tomography (CT) examination had not reached the esophageal foreign body level. Two cases were missed diagnosis because the foreign bodies were too tiny to develop clearly on CT. One case showed foreign body in esophagus during initial CT examination, but after subsequent gastroscopy, no foreign body was found. Among the 12 patients, 7 had esophageal perforation, 1 of which developed a neck abscess, and 1 had peri-esophageal abscess. It seems that, if foreign bodies in the pharynx or esophagus are suspected and no foreign bodies are found in the laryngoscope, chest CT scan is necessary. It is best to perform examination of full-length esophagus and pharynx, because foreign bodies may exist in the post-cricoid region or the deep part of the pyriform sinus, especially in older cases with longer retention times.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"11 1","pages":"e65"},"PeriodicalIF":5.4,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/58/aaem-11-e65.PMC10568947.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41231902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing Medical Errors Using mm-Wave Technology; a Letter to the Editor.","authors":"Andreas G Siamarou","doi":"10.22037/aaem.v11i1.2138","DOIUrl":"10.22037/aaem.v11i1.2138","url":null,"abstract":"Dear editor About 795,000 people die or are permanently disabled each year due to diagnostic errors and related harms across clinical settings, according to estimates based on nationally representative disease incidence data for 2012 to 2014 (1). Studies show that the number of medical errors is increasing annually (2). This undergoing research study has its impact on improving human healthcare and reducing diagnostic errors due to fast, accurate, and robust data storage, transmission, and analysis with the use of information technology (IT) (3). Reducing diagnostics errors using IT in primary care and, generally, in healthcare is limited and huge steps must be taken to establish the use of IT for this purpose. To address this issue, the study proposes the use of ultrafast wireless big data transmission in primary care, specifically in remote smart sensors monitoring devices. It suggests that wireless transmission with a speed up to 100 GB/s (12.5 GBytes/s) within a very short distance (1-10 meters) is necessary to reduce diagnostic errors. High-speed data transfer could facilitate rapid transmission of medical images, such as CT scans, MRIs, or ultrasound images, between different systems or departments within the hospital. This would allow for faster interpretation and analysis of critical medical data, aiding in the diagnosis and treatment of patients in the ICU. The ability to transmit large amounts of data quickly, could facilitate telemedicine applications. For instance, doctors or specialists located remotely could have real-time access to patient data, video feeds, and diagnostic images, allowing them to provide expert consultations without being physically present in the ICU. Using a controlled experimental setup that mimics the challenges and requirements of an Intensive Care Unit (ICU),","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"11 1","pages":"e64"},"PeriodicalIF":5.4,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/77/aaem-11-e64.PMC10568942.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41231920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leuko-Glycemic Index in the Prognosis of Acute Myocardial Infarction; a Cohort Study on Coronary Angiography and Angioplasty Registry.","authors":"Roxana Sadeghi,&nbsp;Mohammad Haji Aghajani,&nbsp;Reza Parandin,&nbsp;Niloufar Taherpour,&nbsp;Koohyar Ahmadzadeh,&nbsp;Arash Sarveazad","doi":"10.22037/aaem.v11i1.2085","DOIUrl":"10.22037/aaem.v11i1.2085","url":null,"abstract":"<p><strong>Introduction: </strong>The leuko-glycemic index (LGI), a combined index of patient leukocyte counts and blood glucose levels, has been shown to predict the prognosis of myocardial infarction (MI) patients. Our study aims to investigate the performance of LGI in prediction of outcomes in a population of diabetic and non-diabetic MI patients.</p><p><strong>Methods: </strong>This observational registry-based cohort study was performed on acute myocardial infarction (AMI) patients. Participants were sub-grouped according to their diabetes status and the calculated optimal LGI cut-off value. The outcomes of the study were the length of hospital stay, and in-hospital and 30-day mortality.</p><p><strong>Results: </strong>A total of 296 AMI (112 diabetic and 184 non-diabetic) patients were included in the study. The optimal cut-off value of LGI in the diabetic and non-diabetic groups was calculated as 2970.4 mg/dl.mm³ and 2249.4 mg/dl.mm³, respectively. High LGI was associated with increased hospital admission duration in non-diabetic patients (p = 0.017). The area under the curve (AUC) of LGI for prediction of in-hospital mortality was 0.93 (95% CI: 0.87 to 1.00) in the diabetic group and 0.92 (95% CI: 0.85 to 0.99) in the non-diabetic group. LGI had a sensitivity and specificity of 90.00%, and 93.14% in prediction of in-hospital mortality in the diabetic group compared to 77.77% and 90.85% in the non-diabetic group. We observed 4 post-discharge mortalities in our patient group.</p><p><strong>Conclusion: </strong>Our study demonstrated that higher LGI predicts in-hospital mortality in both diabetic and non-diabetic patients, while the length of hospital stay was only predicted by LGI levels in non-diabetic patients.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"11 1","pages":"e63"},"PeriodicalIF":5.4,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/35/e7/aaem-11-e63.PMC10568944.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41231904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Ultrasonography for Identification of Elbow Fractures in Children; a Systematic Review and Meta-analysis.","authors":"Seyed Mehdi Hosseini Khameneh,&nbsp;Reza Amani-Beni,&nbsp;Seyed-Amirabbas Ahadiat,&nbsp;Mohammad Saeed Kahrizi,&nbsp;Sina Jafari,&nbsp;Seyedehatefe Seyedinnavade,&nbsp;Amir Masood Rafie Manzelat,&nbsp;Noushin Mashatan,&nbsp;Dorsa Beheshtiparvar,&nbsp;Atousa Moghadam Fard,&nbsp;Hamed Lotfi,&nbsp;Hossein Arhami,&nbsp;Reza Barati,&nbsp;Raziyeh Hasanvand,&nbsp;Shima Boorboor,&nbsp;Elaheh Khodaei,&nbsp;Dorsa Dadashzadehasl,&nbsp;Fatemeh Zamani,&nbsp;Roya Khorram,&nbsp;Maryam Ebrahimpour,&nbsp;Zeynab Abdollahi,&nbsp;Mohammadreza Shabani,&nbsp;Nariman Latifi,&nbsp;Reza Vafadar,&nbsp;Sepideh Shah Hosseini,&nbsp;Mehran Khodashenas,&nbsp;Seyyed Morteza Kazemi,&nbsp;Reza Minaei Noshahr,&nbsp;Hani Ghayyem,&nbsp;Alireza Farahani,&nbsp;Diba Saeidi,&nbsp;Sajedeh Jadidi,&nbsp;Babak Goodarzy,&nbsp;Mehrdad Farrokhi","doi":"10.22037/aaem.v11i1.2078","DOIUrl":"10.22037/aaem.v11i1.2078","url":null,"abstract":"<p><strong>Introduction: </strong>In spite of the results of previous studies regarding the benefits of ultrasonography for diagnosis of elbow fractures in children, the exact accuracy of this imaging modality is still under debate. Therefore, in this diagnostic systematic review and meta-analysis, we aimed to investigate the accuracy of ultrasonography in this regard.</p><p><strong>Methods: </strong>Two independent reviewers performed systematic search in Web of Science, Embase, PubMed, Cochrane, and Scopus for studies published from inception of these databases to May 2023. Quality assessment of the included studies was performed using Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). Meta-Disc software version 1.4 and Stata statistical software package version 17.0 were used for statistical analysis.</p><p><strong>Results: </strong>A total of 648 studies with 1000 patients were included in the meta-analysis. The pooled sensitivity and specificity were 0.95 (95% CI: 0.93-0.97) and 0.87 (95% CI: 0.84-0.90), respectively. Pooled positive likelihood ratio (PLR) was 6.71 (95% CI: 3.86-11.67), negative likelihood ratio (NLR) was 0.09 (95% CI: 0.03-0.22), and pooled diagnostic odds ratio (DOR) of ultrasonography in detection of elbow fracture in children was 89.85 (95% CI: 31.56-255.8). The area under the summary receiver operating characteristic (ROC) curve for accuracy of ultrasonography in this regard was 0.93. Egger's and Begg's analyses showed that there is no significant publication bias (P=0.11 and P=0.29, respectively).</p><p><strong>Conclusion: </strong>Our meta-analysis revealed that ultrasonography is a relatively promising diagnostic imaging modality for identification of elbow fractures in children. However, clinicians employing ultrasonography for diagnosis of elbow fractures should be aware that studies included in this meta-analysis had limitations regarding methodological quality and are subject to risk of bias. Future high-quality studies with standardization of ultrasonography examination protocol are required to thoroughly validate ultrasonography for elbow fractures.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"11 1","pages":"e62"},"PeriodicalIF":5.4,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/a2/aaem-11-e62.PMC10568949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41231892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}