Point-of-Care Ultrasound for DVT Diagnosis: Insights from Emergency Studies and Meta-Analysis

Deep venous thrombosis (DVT) is a common venous thromboembolic disorder, often caused by factors such as immobility, mechanical compression, venous injury, or increased blood viscosity. Prompt and accurate diagnosis is critical to prevent complications like pulmonary embolism, which carries a high mortality risk. While venography is the gold standard for DVT diagnosis, point-of-care ultrasound (POCUS) has gained attention for its utility in emergency settings. This systematic review and meta-analysis evaluated the diagnostic performance of various POCUS protocols performed in emergency departments (EDs) by emergency physicians. A comprehensive search of databases, including PubMed and Embase, was conducted up to February 2023, following PRISMA guidelines. Twenty-six studies were included, and the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) assessed bias risk. The meta-analysis revealed high diagnostic accuracy for POCUS protocols. The 2-point compression method showed pooled sensitivity and specificity of 92.32% and 96.86%, respectively, while the 3-point technique demonstrated sensitivity and specificity of 89.15% and 92.71%. Whole-leg and complete compression techniques exhibited even higher sensitivity and specificity, both reaching 100% and 97.05%, respectively. Additionally, emergency physician-performed POCUS significantly reduced the time to diagnosis compared to radiologist-led diagnostic imaging. These findings highlight that POCUS is an effective and time-efficient first-line imaging tool for DVT diagnosis in EDs. Emergency physicians with minimal training in POCUS protocols can achieve excellent diagnostic accuracy. Incorporating trained emergency physicians into DVT evaluation workflows can further enhance diagnostic outcomes.