Correlation between CUS and DUS for DVT diagnosis in lower extremities in the emergency department

Abstract

Background: Deep venous thrombosis (DVT) is one of the most serious thrombotic events and one of the most common cardiovascular causes associated with death due to pulmonary embolism in the emergency department. Objectives: This study aimed to determine the correlation between two-point compression ultrasonography (CUStwo-point) and doppler ultrasound (DUS) in the diagnosis of DVT of the lower extremities. Methods: This descriptive–analytical cross-sectional study was conducted on all patients with suspected DVT referred to two emergency departments over 6 months. Initially, all patients underwent CUStwo-point using a linear probe on the common femoral and popliteal veins, which was performed by an emergency medicine specialist. Then DUS was performed on all patients by radiologists who were unaware of the results of CUStwo-point. The results obtained from the two procedures were recorded in a data collection form by a third-year emergency medicine assistant. The data was analyzed by SPSS 23 software. Results: Overall, 129 patients were enrolled, the mean age of whom was 56.18 ± 16.33.68 years. There were 68 males (52.7%) and 61 females (47.3%) among the participants. The positivity or negativity of the data retrieved from CUStwo-point and DUS was assessed by the McNemar test, and a P-value of 1 indicated the homogeneity of both tests. Compared to DUS (as the gold standard), the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CUStwo-point method were obtained as 97.56%, 95.74%, 97.56%, 95.74%, and 96.9%, respectively. The accuracy of 96.9% of CUStwo-point along with Cohen’s kappa of 0.93 indicated a high agreement between the two ultrasound methods. Conclusion: CUS seems to be a non-invasive, safe, and accessible method in the emergency department that can provide an appropriate alternative to DUS for the diagnosis of DVT in the lower extremities.