Accuracy of three-point compression ultrasound for the diagnosis of proximal deep-vein thrombosis in emergency department

Background:  This study aimed to assess the accuracy of three‑point compression ultrasonography  (3PCUS) performed for the diagnosis of proximal deep‑vein thrombosis  (DVT) in Emergency Department  (ED) compared with the results of duplex US (DUS) (whole‑leg compression ultrasound). Materials and Methods: The current prospective cross‑sectional study with diagnostic test assessment was conducted on adult patients who were referred to the ED of a general teaching hospital in Shiraz, southern part of Iran (September 2016–May 2017), suspected of lower‑extremity DVT, using a convenience sampling. The results of 3PCUS performed by ED residents were compared with the results of DUS performed by the radiology residents, which was considered as a criterion standard. Results: A total of 240 patients were enrolled, with a mean (standard deviation) age of 59.46 (16.58). 3PCUS has a sensitivity and a specificity of 100% (95% confidence interval [CI], 96.55%–100%) and 93.33% (95% CI, 87.72%–96.91%), respectively, in comparison with DUS (whole‑leg compression ultrasound). Negative predictive value and positive predictive value were 100% and 92.11% (95% CI, 86.12%–95.64%), respectively, with an accuracy of 96.25% (95% CI, 93%–98.27%). Conclusion: The results of this study showed that 3PCUS of the lower extremities with a portable US machine, performed by the ED’s residents, can accurately identify the presence or absence of lower‑extremity DVT.