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

• Published in: Archives of academic emergency medicine Vol. 11; no. 1; p. e49
• Main Authors: Rahmani, Erfan, Fayyazishishavan, Ehsan, Afzalian, Arian, Varshochi, Sanaz, Amani-Beni, Reza, Ahadiat, Seyed-Amirabbas, Moshtaghi, Zeynab, Shafagh, Seyyed-Ghavam, Khorram, Roya, Asadollahzade, Elnaz, Atbaei, Raihaneh, Kahrizi, Mohammad Saeed, Rahbari, Atoosa, Baharlouie, Negar, Mostanbet, Farzaneh, Amirabadiquchani, Bahamin, Kiani, Moein, Memarizadeh, Mozhdeh, Keshtkar Rajabi, Shahin, Barati, Reza, Hajinouri, Hengame, Najafi, Shahrzad, Abdollahi, Zeynab, Dadashzadehasl, Nahid, Moghadam Fard, Atousa, Afshar, Mozhgan, Abedi, Atefeh, Saeidi, Sara, Mansourirad, Adeleh, Emami Shahrezaei, Pedram, Shah Hosseini, Sepideh, Rostami Ghotbabadi, Zahra, Vafadar, Reza, Roohinezhad, Roozbeh, Ghalamkarpour, Nogol, Farrokhi, Mehrdad
• Format: Journal Article
• Language: English
• Published: Tehran, Iran Shahid Beheshti University of Medical Sciences 01-01-2023
• Subjects: Abscess; cellulitis; diagnostic imaging; meta-analysis; Review; ultrasonography
• ISSN: 2645-4904
• DOI: 10.22037/aaem.v11i1.2021

IntroductionDifferentiating 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. MethodsA 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). ResultsThe 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. ConclusionOur 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.