Intern Emerg Med. 2025 Sep 15. doi: 10.1007/s11739-025-04115-x. Online ahead of print.
ABSTRACT
Abdominal pain constitutes approximately 10% of all emergency department (ED) presentations, representing a frequent and diagnostically complex complaint. Point-of-care ultrasound (POCUS) has become an essential tool in the ED, supporting resuscitation, interventional procedures, diagnosis, and follow-up. This prospective, randomized-controlled study aimed to assess the impact of POCUS-integrated triage compared to conventional triage (without ultrasound) on diagnostic accuracy, treatment initiation, and ED management in patients with non-traumatic abdominal pain. A total of 262 adult patients were enrolled and randomized in a 1:1 ratio using computer-assisted methods, with 127 allocated to conventional triage and 135 to POCUS triage. The researcher did not intervene in clinical decisions. Primary outcomes included additional imaging requests, time to initial analgesia, consultation requests, ED length of stay, and overall outcome, while the secondary outcome was the effect on triage categorization. Statistical analysis was performed using IBM SPSS Statistics version 21.0. The mean age of participants was 30 years, with 55.7% being female. The POCUS triage group required significantly fewer additional imaging studies (p < 0.001) and had shorter times to analgesia administration, consultation, and ED discharge (all p < 0.001). Moreover, POCUS triage significantly altered patient categorization compared to the Emergency Severity Index (ESI) system (p < 0.001). When compared against final imaging reports, POCUS demonstrated a sensitivity of 87%, specificity of 55%, positive predictive value of 81.6%, and negative predictive value of 64.7%. In conclusion, POCUS triage enhances clinical efficiency by reducing imaging needs and expediting key interventions, offering significant advantages for emergency department workflow and patient care.
PMID:40954383 | DOI:10.1007/s11739-025-04115-x
