PDF(Pubmed)
Abstract：
Purpose The number of B-lines on lung ultrasound at hospital discharge in patients admitted with acute heart failure (AHF) is associated with poor outcomes. Assessing B-lines can be challenging to execute and replicate, depending on the clinical context. This study aims to determine whether the lung ultrasound score (LUS) at discharge predicts hospital readmission or emergency department (ED) visits in the 30 days after an AHF hospital admission. Methods We conducted an observational study at the medical ward of the emergency unit of the Clinics Hospital of the Ribeirao Preto Medical School, University of Sao Paulo, a tertiary university hospital in Ribeirao Preto, Sao Paulo, Brazil, where consecutive adults admitted with AHF were included. On the day of hospital discharge, we measured the LUS and tracked these patients for up to 30 days to monitor emergency department visits, hospital readmission, and the number of days free from hospital stay. Results A total of 46 patients were included in the study. A composite outcome of ED visits or hospital readmission in the 30 days after hospital discharge was achieved for 22 (47.8%) patients. The LUS at hospital discharge had a receiver operating characteristic (ROC) area of 0.93 (95% CI, 0.82-0.99) to predict the composite outcome, against 0.67 (95% CI, 0.52-0.81) for the clinical congestion score (CCS). A LUS ≥ 7 at discharge had a sensitivity of 95.5% and a specificity of 87.5% to predict the composite outcome. The average exam duration was 176±65 (sd) seconds. Conclusions The LUS at hospital discharge following admission for AHF proves to be an accurate tool for predicting the likelihood of return to the ED and/or hospital readmission within 30 days post discharge.
摘要：
目的：急性心力衰竭（AHF）患者出院时肺部超声的B线数量与不良预后相关。评估B线的执行和复制可能具有挑战性，取决于临床背景。这项研究旨在确定出院时的肺部超声评分（LUS）是否可以预测AHF入院后30天内的再入院或急诊科（ED）就诊。方法我们在RibeiraoPreto医学院临床医院急诊病房进行了观察性研究，圣保罗大学,里贝罗·普雷托的一所三级大学医院，圣保罗,巴西,包括连续入院的AHF成年人。出院那天,我们测量了LUS并跟踪这些患者长达30天，以监测急诊科就诊情况，医院再入院,以及住院后的免费天数。结果共纳入46例患者。22名（47.8％）患者在出院后30天内实现了ED就诊或再次入院的复合结局。出院时的LUS具有0.93（95％CI，0.82-0.99）的受试者工作特征（ROC）面积来预测复合结局，临床充血评分（CCS）为0.67（95%CI，0.52-0.81）。出院时LUS≥7对预测复合结局的敏感性为95.5%，特异性为87.5%。平均检查持续时间为176±65(sd)秒。结论AHF入院后出院时的LUS被证明是预测出院后30天内重返ED和/或再次入院的可能性的准确工具。
