Diagnostic Accuracy of Point-of-Care Ultrasound for Patients With Cardiogenic Shock - A Meta-Analysis and Systematic Review.

BACKGROUND

Cardiogenic shock, cardiac tamponade, and pulmonary embolism are critical conditions in cardiovascular emergencies, characterized by high mortality rates. Early diagnosis and treatment are essential to improve outcomes. Point-of-care ultrasound (POCUS) has emerged as a noninvasive tool for evaluating shock. However, further assessment through the latest meta-analyses is necessary to comprehensively evaluate its diagnostic accuracy in cardiogenic emergencies. Therefore, in this study, we conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of POCUS in patients with cardiogenic and obstructive shock.

METHODS AND RESULTS

Up to December 31, 2023, we systematically reviewed 9 studies reporting all 4 values (true positive, false positive, false negative, and true negative) published in the PubMed, Web of Science, and CENTRAL databases: 8 studies assessed cardiac shock, and 8 assessed obstructive shock separately. For cardiac shock, the pooled sensitivity was 86.1% (95% confidence interval [CI]: 71.5-93.9%), and specificity was 95.8% (95% CI: 94.0-97.2%). For obstructive shock, the pooled sensitivity was 77.5% (95% CI: 62.5-87.6%) and specificity was 97.6% (95% CI: 93.9-99.1%). The area under the curve was 0.96 (95% CI: 0.95-0.98) for cardiogenic shock and 0.94 (95% CI: 0.88-0.98) for obstructive shock.

CONCLUSIONS

This meta-analysis suggested that POCUS has reasonable diagnostic accuracy for cardiogenic and obstructive shock, particularly with high pooled specificity.