Low Diagnostic Accuracy of Transthoracic Ultrasound for the Assessment of Spontaneous Pneumothorax in the Emergency Setting: A Multicentric Study Article Swipe
YOU?
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· 2024
· Open Access
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· DOI: https://doi.org/10.3390/jcm13164861
Background: Pneumothorax (PNX) represents a common clinical condition in emergency departments (EDs), requiring prompt recognition and treatment. The role of transthoracic ultrasounds (TUSs) in the diagnosis of PNX is still debated. We aimed to prospectively evaluate the accuracy of TUSs in the detection of spontaneous PNX in EDs. Methods: A total of 637 consecutive adult patients who presented to the EDs of four Italian hospitals complaining of acutely onset chest pain and dyspnoea were included in the study. Exclusion criteria were previous traumatic events, cardiogenic causes of pain/dyspnoea and suspected tension PNX. The absence of “lung sliding” (B-mode) and the “bar-code” sign (M-mode) were considered indicative of PNX in a TUS. Accuracy, sensitivity, specificity, and positive and negative predictive values (PPVs, NPVs) were calculated using a chest CT scan as reference. Results: Spontaneous PNX occurred in 93 patients: of those, 83 (89.2%) were correctly identified by TUSs. However, 306 patients with suspected PNX at TUS were not confirmed by chest CTs. The diagnostic accuracy of both the absence of “lung sliding” and “bar-code” sign during TUS was 50.4% (95% CI: 46.4–54.3), sensitivity was 89.2% (95% CI: 81.1–94.7), specificity was 43.8% (95% CI: 39.5–48.0), the PPV was 21.3% (95% CI: 19.7–23.1) and the NPV was 96.0% (95% CI: 92.9–97.7). Conclusions: TUS showed high sensitivity but low specificity in the identification of PNX in EDs. Relying exclusively on TUSs results for patients’ management in ED settings is neither suitable nor recommendable. TUS examination can be useful to strengthen the clinical suspicion of PNX, but its results should be confirmed by a chest X-ray or CT scan.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3390/jcm13164861
- https://www.mdpi.com/2077-0383/13/16/4861/pdf?version=1723887374
- OA Status
- gold
- Cited By
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- References
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- Related Works
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- OpenAlex ID
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Raw OpenAlex JSON
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https://openalex.org/W4401703462Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3390/jcm13164861Digital Object Identifier
- Title
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Low Diagnostic Accuracy of Transthoracic Ultrasound for the Assessment of Spontaneous Pneumothorax in the Emergency Setting: A Multicentric StudyWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-08-17Full publication date if available
- Authors
-
Carla Maria Irene Quarato, Antonio Mirijello, Marialuisa Bocchino, Beatrice Feragalli, Donato Lacedonia, Gaetano Rea, Roberta Lieto, Michele Maria Maggi, Anela Hoxhallari, Giulia Scioscia, Aldo Vicario, Giuseppe Pellegrino, Luca Pazienza, Rosanna Villani, Salvatore Bellanova, Pierluigi Bracciale, Stefano Notarangelo, Paride Morlino, Salvatore De Cosmo, Marco SperandeoList of authors in order
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https://doi.org/10.3390/jcm13164861Publisher landing page
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https://www.mdpi.com/2077-0383/13/16/4861/pdf?version=1723887374Direct link to full text PDF
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goldOpen access status per OpenAlex
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https://www.mdpi.com/2077-0383/13/16/4861/pdf?version=1723887374Direct OA link when available
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Medicine, Pneumothorax, Ultrasound, Emergency ultrasound, Emergency department, Radiology, Emergency medicine, Diagnostic accuracy, Medical emergency, Medical physics, NursingTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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40Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.NPV | 202 |
| abstract_inverted_index.PNX | 27, 45, 107, 133, 152, 220 |
| abstract_inverted_index.PPV | 194 |
| abstract_inverted_index.TUS | 154, 175, 209, 239 |
| abstract_inverted_index.The | 17, 92, 161 |
| abstract_inverted_index.and | 15, 71, 88, 98, 114, 116, 171, 200 |
| abstract_inverted_index.but | 213, 251 |
| abstract_inverted_index.can | 241 |
| abstract_inverted_index.for | 228 |
| abstract_inverted_index.its | 252 |
| abstract_inverted_index.low | 214 |
| abstract_inverted_index.nor | 237 |
| abstract_inverted_index.not | 156 |
| abstract_inverted_index.the | 24, 36, 41, 59, 76, 99, 166, 193, 201, 217, 246 |
| abstract_inverted_index.was | 176, 182, 188, 195, 203 |
| abstract_inverted_index.who | 56 |
| abstract_inverted_index.(95% | 178, 184, 190, 197, 205 |
| abstract_inverted_index.CTs. | 160 |
| abstract_inverted_index.EDs. | 47, 222 |
| abstract_inverted_index.PNX, | 250 |
| abstract_inverted_index.PNX. | 91 |
| abstract_inverted_index.TUS. | 110 |
| abstract_inverted_index.TUSs | 39, 226 |
| abstract_inverted_index.both | 165 |
| abstract_inverted_index.four | 62 |
| abstract_inverted_index.high | 211 |
| abstract_inverted_index.pain | 70 |
| abstract_inverted_index.role | 18 |
| abstract_inverted_index.scan | 128 |
| abstract_inverted_index.sign | 101, 173 |
| abstract_inverted_index.were | 73, 80, 103, 122, 142, 155 |
| abstract_inverted_index.with | 150 |
| abstract_inverted_index.(PNX) | 2 |
| abstract_inverted_index.21.3% | 196 |
| abstract_inverted_index.43.8% | 189 |
| abstract_inverted_index.50.4% | 177 |
| abstract_inverted_index.89.2% | 183 |
| abstract_inverted_index.96.0% | 204 |
| abstract_inverted_index.NPVs) | 121 |
| abstract_inverted_index.TUSs. | 146 |
| abstract_inverted_index.X-ray | 260 |
| abstract_inverted_index.adult | 54 |
| abstract_inverted_index.aimed | 32 |
| abstract_inverted_index.chest | 69, 126, 159, 259 |
| abstract_inverted_index.onset | 68 |
| abstract_inverted_index.scan. | 263 |
| abstract_inverted_index.still | 29 |
| abstract_inverted_index.total | 50 |
| abstract_inverted_index.using | 124 |
| abstract_inverted_index.(EDs), | 11 |
| abstract_inverted_index.(PPVs, | 120 |
| abstract_inverted_index.(TUSs) | 22 |
| abstract_inverted_index.causes | 85 |
| abstract_inverted_index.common | 5 |
| abstract_inverted_index.during | 174 |
| abstract_inverted_index.prompt | 13 |
| abstract_inverted_index.should | 254 |
| abstract_inverted_index.showed | 210 |
| abstract_inverted_index.study. | 77 |
| abstract_inverted_index.those, | 139 |
| abstract_inverted_index.useful | 243 |
| abstract_inverted_index.values | 119 |
| abstract_inverted_index.(89.2%) | 141 |
| abstract_inverted_index.Italian | 63 |
| abstract_inverted_index.Relying | 223 |
| abstract_inverted_index.absence | 93, 167 |
| abstract_inverted_index.acutely | 67 |
| abstract_inverted_index.events, | 83 |
| abstract_inverted_index.neither | 235 |
| abstract_inverted_index.results | 227, 253 |
| abstract_inverted_index.tension | 90 |
| abstract_inverted_index.“lung | 95, 169 |
| abstract_inverted_index.(B-mode) | 97 |
| abstract_inverted_index.(M-mode) | 102 |
| abstract_inverted_index.However, | 147 |
| abstract_inverted_index.Methods: | 48 |
| abstract_inverted_index.Results: | 131 |
| abstract_inverted_index.accuracy | 37, 163 |
| abstract_inverted_index.clinical | 6, 247 |
| abstract_inverted_index.criteria | 79 |
| abstract_inverted_index.debated. | 30 |
| abstract_inverted_index.dyspnoea | 72 |
| abstract_inverted_index.evaluate | 35 |
| abstract_inverted_index.included | 74 |
| abstract_inverted_index.negative | 117 |
| abstract_inverted_index.occurred | 134 |
| abstract_inverted_index.patients | 55, 149 |
| abstract_inverted_index.positive | 115 |
| abstract_inverted_index.previous | 81 |
| abstract_inverted_index.settings | 233 |
| abstract_inverted_index.suitable | 236 |
| abstract_inverted_index.Accuracy, | 111 |
| abstract_inverted_index.Exclusion | 78 |
| abstract_inverted_index.condition | 7 |
| abstract_inverted_index.confirmed | 157, 256 |
| abstract_inverted_index.correctly | 143 |
| abstract_inverted_index.detection | 42 |
| abstract_inverted_index.diagnosis | 25 |
| abstract_inverted_index.emergency | 9 |
| abstract_inverted_index.hospitals | 64 |
| abstract_inverted_index.patients: | 137 |
| abstract_inverted_index.presented | 57 |
| abstract_inverted_index.requiring | 12 |
| abstract_inverted_index.suspected | 89, 151 |
| abstract_inverted_index.suspicion | 248 |
| abstract_inverted_index.traumatic | 82 |
| abstract_inverted_index.calculated | 123 |
| abstract_inverted_index.considered | 104 |
| abstract_inverted_index.diagnostic | 162 |
| abstract_inverted_index.identified | 144 |
| abstract_inverted_index.indicative | 105 |
| abstract_inverted_index.management | 230 |
| abstract_inverted_index.predictive | 118 |
| abstract_inverted_index.reference. | 130 |
| abstract_inverted_index.represents | 3 |
| abstract_inverted_index.sliding” | 96, 170 |
| abstract_inverted_index.strengthen | 245 |
| abstract_inverted_index.treatment. | 16 |
| abstract_inverted_index.Background: | 0 |
| abstract_inverted_index.Spontaneous | 132 |
| abstract_inverted_index.cardiogenic | 84 |
| abstract_inverted_index.complaining | 65 |
| abstract_inverted_index.consecutive | 53 |
| abstract_inverted_index.departments | 10 |
| abstract_inverted_index.examination | 240 |
| abstract_inverted_index.exclusively | 224 |
| abstract_inverted_index.patients’ | 229 |
| abstract_inverted_index.recognition | 14 |
| abstract_inverted_index.sensitivity | 181, 212 |
| abstract_inverted_index.specificity | 187, 215 |
| abstract_inverted_index.spontaneous | 44 |
| abstract_inverted_index.ultrasounds | 21 |
| abstract_inverted_index.19.7–23.1) | 199 |
| abstract_inverted_index.Conclusions: | 208 |
| abstract_inverted_index.Pneumothorax | 1 |
| abstract_inverted_index.sensitivity, | 112 |
| abstract_inverted_index.specificity, | 113 |
| abstract_inverted_index.39.5–48.0), | 192 |
| abstract_inverted_index.46.4–54.3), | 180 |
| abstract_inverted_index.81.1–94.7), | 186 |
| abstract_inverted_index.92.9–97.7). | 207 |
| abstract_inverted_index.pain/dyspnoea | 87 |
| abstract_inverted_index.prospectively | 34 |
| abstract_inverted_index.transthoracic | 20 |
| abstract_inverted_index.identification | 218 |
| abstract_inverted_index.recommendable. | 238 |
| abstract_inverted_index.“bar-code” | 100, 172 |
| cited_by_percentile_year.max | 95 |
| cited_by_percentile_year.min | 91 |
| corresponding_author_ids | https://openalex.org/A5073902502, https://openalex.org/A5065456103 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 20 |
| corresponding_institution_ids | https://openalex.org/I2800188116, https://openalex.org/I4210153126 |
| citation_normalized_percentile.value | 0.67058466 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |