Comparison of the effectiveness of focused point-of-care ultrasonography triage and classical triage in patients presenting to the emergency department with abdominal pain

AIM: This study aimed to investigate the impact of classical triage and classical triage supplemented with Point-of-Care Ultrasonography (POCUS) on diagnosis, treatment, emergency department management, and their relationship with triage models in patients presenting to the emergency department with abdominal pain. MATERIALS AND METHODS: This randomized, controlled, prospective study included 262 voluntary participants divided into two groups: 127 patients underwent classical triage, and 135 patients underwent classical triage supplemented with POCUS. Participants were assigned to groups in a 1:1 ratio using a computer-assisted randomization table. Researchers did not intervene in clinical processes. The primary outcomes assessed were the effects of POCUS on clinical processes (imaging requests, time to first analgesia administration, consultation requests, length of stay in the emergency department, and outcomes). The secondary outcome was the impact of POCUS on triage systems. Statistical analysis was performed using IBM SPSS 21.0 software. RESULTS: The mean age of participants was 30 years, and 55,7% were female. POCUS supplementation in classical triage improved the accuracy of categorization in the ESI triage system (p<0,001). It also reduced the number of additional imaging requests (p<0,001), shortened the time to first analgesia administration, consultation requests, and length of stay in the emergency department (p<0,001). Sensitivity, specificity, positive predictive value, and negative predictive value of POCUS compared to additional imaging reports were 87%, 55%, 81,6%, and 64,7%, respectively. CONCLUSION: POCUS supplementation in classical triage positively impacts emergency department operations by reducing the number of additional imaging requests and shortening the time to first analgesia administration, consultation requests, and length of stay. It also improves the accuracy of ESI triage categorization. However, as this is the first study to evaluate POCUS in the triage setting, further studies are needed to support these findings. Keywords: Abdominal pain, triage, POCUS, emergency department