Loss of Lung Sliding Sign Ultrasonography for Pneumothorax
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Abstract
Background: Pneumothorax is the common medical emergency condition of the emergency department and requires prompt diagnosis to reduce mortality especially, in unstable cases. The gold standard diagnosis for pneumothorax is CT chest, but in Buriram hospital use lung ultrasonography to diagnose instead of CT chest because it is convenient, fast, and sometimes the patients cannot be moved to the CT room.
Objective: The purpose of this study was to evaluate the accuracy of lung ultrasonography for the diagnosis of pneumothorax in the emergency department.
Methods: The research was a diagnostic accuracy research, retrospective cross-sectiona (case-control analogue) design, based on medical records of patients suspected of pneumothorax that were admitted to the emergency department at Buriram Hospital from September 1st, 2018 to November 30th, 2020. The researcher reviewed medical records of 128 patients .They were divided into two groups, namely 41 patients confirmed pneumothorax and 87 patients without pneumothorax. To determine the diagnostic accuracy and predictive value of lung ultrasonography in the diagnosis of pneumothorax were compare with CT chest or air release on chest tube placement.
Results: The diagnosis of pneumothorax using lung ultrasonography at the emergency department showed sensitivity of 75.6% (95%CI:59.7- 87.6), specificity of 92% (95%CI:84.1-96.7), Positive predictive valueof 81.6% (95%CI:65.7-92.3), and Negative predictive value of 88.9% (95%CI:80.5-94.5).
Conclusion: The diagnosis of pneumothorax by using lung ultrasonography at the emergency department shows high accuracy. Therefore, it was suitable for diagnose pneumothorax in emergency cases that are not be able to confirmed with CT chest. However, lung sliding sign testalone may decrease accuracy. If there is an opportunity for further studies, other signs should be used to increase the accuracy of diagnosis of pneumothorax.
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