Archives of Academic Emergency Medicine (Jul 2023)

Point-Of-Care Ultrasonography for Identification of Skin and Soft Tissue Abscess in Adult and Pediatric Patients; a Systematic Review and Meta-Analysis

  • Erfan Rahmani,
  • Ehsan Fayyazishishavan,
  • Arian Afzalian,
  • Sanaz Varshochi,
  • Reza Amani-Beni,
  • Seyed-Amirabbas Ahadiat,
  • Zeynab Moshtaghi,
  • Seyyed-Ghavam Shafagh,
  • Roya Khorram,
  • Elnaz Asadollahzade,
  • Raihaneh Atbaei,
  • Mohammad Saeed Kahrizi,
  • Atoosa Rahbari,
  • Negar Baharlouie,
  • Farzaneh Mostanbet,
  • Bahamin Amirabadiquchani,
  • Moein Kiani,
  • Mozhdeh Memarizadeh,
  • Shahin Keshtkar Rajabi,
  • Reza Barati,
  • Hengame Hajinouri,
  • Shahrzad Najafi,
  • Zeynab Abdollahi,
  • Nahid Dadashzadehasl,
  • Atousa Moghadam Fard,
  • Mozhgan Afshar,
  • Atefeh Abedi,
  • Sara Saeidi,
  • Adeleh Mansourirad,
  • Pedram Emami Sharezaei,
  • Sepideh Shah Hosseini,
  • Zahra Rostami Ghotbabadi,
  • Reza Vafadar,
  • Roozbeh Roohinezhad,
  • Nogol Ghalamkarpour,
  • Mehrdad Farrokhi

Journal volume & issue
Vol. 11, no. 1

Abstract

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Introduction: Differentiating the soft tissue abscess from other types of skin and soft tissue infections (SSTIs) poses a particular challenge because they have similar physical evaluation findings, but each disease has a different course, outcome, and treatment. This meta-analysis aimed to investigate the diagnostic accuracy of point-of-care ultrasonography for diagnosis of soft tissue abscess in the emergency departments. Methods: A comprehensive literature search of MEDLINE, Scopus, Web of Science, Embase, and Google Scholar, from inception to January 2023, was conducted to identify relevant studies investigating the diagnostic performance of point-of-care ultrasonography for identification of abscess. Methodological quality of the included studies was assessed using a revised tool for the quality assessment of diagnostic accuracy studies (QUADAS-2). Results: The pooled estimates of diagnostic parameters of ultrasonography for diagnosis of abscess were as follows: sensitivity, 0.93 (95% CI: 0.92–0.94); specificity, 0.87 (95% CI: 0.85–0.89), and the area under the summary receiver-operating characteristic (SROC), 0.95. The pooled sensitivity, specificity, and area under the SROC of studies in adult patients were 0.98 (95% CI: 0.92–1), 0.92 (95% CI: 0.86–0.95), and 0.99, respectively. The pooled sensitivity, specificity, and area under the SROC of studies in pediatric patients were 0.9 (95% CI: 0.87–0.92), 0.78 (95% CI: 0.73–0.82), and 0.91, respectively. Conclusion: Our meta-analysis demonstrated that the point-of-care ultrasonography has excellent diagnostic value for the abscess in the emergency department. Furthermore, we found that the diagnostic performance of point-of-care ultrasonography for diagnosis of abscess was higher for adult cases than for pediatric patients.

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