B-lines in lung ultrasonography as prognostic markers for community-acquired pneumonia

Abstract

Objective: Community-acquired pneumonia (CAP) is a type of pneumonia with high morbidity and mortality rates in high-risk groups. It is a common reason for referral to the emergency room. A prognostic marker that can be used quickly and easily at the bedside in the emergency room without a blood test and the need to transfer the patient to another department can contribute to quick determination of the best treatment and nursing protocol. Methods: This prospective study included patients with CAP who were referred to the emergency room. CURB-65 and the pneumonia severity index (PSI) were calculated for each patient and were used as reference scores that were compared to a B-line score (BLS) that we developed based on B-line artifacts from lung ultrasonography (LUSG). The CURB-65, PSI, and BLS values compared in terms of need for hospitalization and 30-day mortality. Results: A total of 72 patients were included in the study. Their mean age was 64.60 +/- 17.28 years. Of all the factors examined, the BLS showed statistically significant results in terms of mortality and differences between inpatients and outpatients. The AUC value of the BLS and 30-day mortality was 0.753 (95% CI: 0.594-0.911). The maximum likelihood ratio was 3.2. Conclusion: Although randomized, blind, controlled studies are required to evaluate the prognostic effectiveness of the scoring system that we developed based on B-lines in CAP patients' LUSG, we believe that LUSG images can provide valuable prognostic information and that B-line artifacts can be taken into consideration in this respect.