The diagnostic accuracy of multi-organ point-of-care ultrasonography for life-threatening conditions: The case of cancer patients who visit the emergency department: retrospective observational study

Abstract Background The number of cancer patients visiting the emergency department (ED) is increasing globally, and this has highlighted the importance of diagnosing and coping with related life-threatening complications early. There may be efficacy in employing multi-organ point-of-care ultrasonography (M-PoCUS) for this purpose; however, there has been no study on the usefulness of this diagnostic tool for cancer patients only. The aim of this study was to evaluate the diagnostic accuracy of M-PoCUS for a life-threatening condition in cancer patients who visited the ED. Methods We conducted a retrospective observational study in one tertiary university hospital ED in Seoul, Republic of Korea. We selected three emergency medicine specialists to perform a protocolized M-PoCUS evaluation of cancer patients according to the requests of emergency physicians since the SARS-CoV-2 pandemic began. We enrolled 94 cancer patients in the study. The M-PoCUS diagnosis was then compared with an audit diagnosis. The primary outcomes measured were the sensitivity, specificity, positive predictive value, and negative predictive value of M-PoCUS in the above-described diagnosis. Results The M-PoCUS showed a sensitivity of 83% (95% CI, 61-95), specificity of 96% (95% CI, 88-99), positive predictive value of 86% (95% CI, 65-97), and negative predictive value of 94% (95% CI, 85-97). M-PoCUS produced 4 false negative (4.3%) pulmonary thromboembolism diagnoses and 3 false positive (3.2%) pleural effusion diagnoses. Conclusions M-PoCUS was useful in ruling out a life-threatening condition among the cancer patients. However, pulmonary thromboembolism was hard to distinguish using M-PoCUS due to pre-existing diseases scattered in cancer patients’ thorax.