DIAGNOSTIC ACCURACY OF POINT OF CARE ULTRASOUND IN ADULT PATIENTS PRESENTING WITH ACUTE DYSPNEA TO EMERGENCY DEPARTMENT

Background Lung ultrasonography as a diagnostic tool in various specialized and clinical contexts are all becoming more and more supported by data. Emergency physicians are actively researching and implementing focused multidimensional ultrasound as a mode of care technique because of the urgent requirement for diagnosis in the ED. However, research from local settings are scarce. Objective To ascertain the diagnostic accuracy of POCUS in identifying the different causes of sudden onset dyspnea taking final clinical diagnosis as gold standard. Materials and Methods A total of 219 male and female patients aging 20 to 60 years presenting with acute shortness of breath were enrolled at the department of emergency medicine, CMH Rawalpindi during the period 15th April 2022 till 14th April 2024. A point of care ultrasound was performed and findings were compared with final clinical diagnosis by emergency specialist. 2x2 table was used to draw the diagnostic accuracy. Results Mean age of the participants was 35.44±10.887 years with majority of the patient in the age group less than 40 years (n = 161, 73.5%) while male participants were 138 (63.0%), MRC grade 5 dyspnea was more common (n = 127, 58.0%). The sensitivity of POCUS for pneumonia was 23.5% and specificity was 76.7%. The kappa value for agreement was 0.027. The sensitivity of POCUS for pulmonary edema was 10.2%, specificity was 89.4% and kappa value was 0.004. Conclusion PoCUS exhibits considerable screening potential for various clinical conditions presenting with acute shortness of breath. It enables swift interpretations by integrating its comprehensive reliability, agreement with the ultimate composite diagnosis.