Evaluation of Compatibility Between Emergency Physicians and Cardiologists in Measuring Pulmonary Artery Pressure: A Prospective, Observational Study

Abstract

Aim:To evaluate the degree of agreement between emergency physicians (EPs) and cardiologists in measuring pulmonary arterial pressure (PAP) (measurement with simplified Bernoulli equation).Materials and Methods:This prospective observational study was conducted between January 2020 and January 2022 in the University of Health Sciences Turkey, Antalya Training and Research Hospital, Clinic of Emergency Medicine, a tertiary hospital. Sample size calculation: According to the kappa (2 raters) - Hypothesis testing method: Assuming minimum acceptable kappa 0.6 and Expected kappa 0.85, significance level 0.05, and Power 90%, including the Expected dropout rate of 10% in the study, 117 patients were included in the study. Demographic findings, personal history, laboratory tests, and PAP values of the patients calculated by the EPs and cardiologists were recorded.Results:The study included 117 patients who attended the emergency department with shortness of breath or chest pain complaints. While 72.6% of them are female, 27.4% are male patients. The age of the patients included in the study was a minimum of 33 and a maximum of 80. Their mean age and deviation were 59.6±10.6. A near-perfect agreement was found between the measurements of the cardiologist and the EP according to the criteria for PAP measurement ≤20 and >20 (Cohen’s kappa coefficient 0.86; <0.0001).Conclusion:We found near-perfect agreement between cardiologists and emergency room physicians trained in focused cardiac ultrasound (FoCUS) in detecting normal or increased PAP.

Keywords

• pulmonary artery pressure
• chest pain
• dyspnea
• focused cardiac ultrasound
• emergency medicine