Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand.
Division of Cardiology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand.
BMC Cardiovasc Disord. 2022 Jul 24;22(1):330. doi: 10.1186/s12872-022-02781-9.
More than 50% of patients admitted for acute heart failure are discharged with residual pulmonary congestion. Residual pulmonary congestion at discharge is associated with rehospitalization and death within 6 months after discharge. B-lines detected by lung ultrasound are the sonographic manifestation of pulmonary congestion, a major predictor of morbidity and mortality in patients with heart failure. The present study was performed to evaluate the prognostic value of B-lines at discharge for prediction of rehospitalization and death at 6 months in patients with acute heart failure.
This study involved a prospective cohort of 126 patients admitted to Ramathibodi Hospital for acute heart failure (mean age, 69 ± 15 years). B-lines and the size of the inferior vena cava were assessed within 24 h before discharge. The patients were followed up for 6 months after discharge.
The mean number of B-lines at discharge was 9 ± 9, and the rate of rehospitalization within 6 months was significantly higher in patients with a significant number of B-lines (≥ 12) than in patients with a non-significant number of B-lines (< 12) (log rank χ = 7.74, P = 0.004). In the univariable analysis, the presence of ≥ 12 B-lines before discharge (hazard ratio = 2.15, 95% confidence interval = 1.27-3.63) was an independent predictor of events at 6 months.
Residual pulmonary congestion before discharge as detected by point-of-care lung ultrasound predicts rehospitalization for heart failure at 6 months. The presence of non-significant B-lines identifies a subgroup at low risk of rehospitalization for heart failure.
超过 50%因急性心力衰竭入院的患者出院时仍有肺淤血。出院时仍有肺淤血与出院后 6 个月内再住院和死亡相关。肺部超声检测到的 B 线是肺淤血的超声表现，是心力衰竭患者发病率和死亡率的主要预测指标。本研究旨在评估出院时 B 线对预测急性心力衰竭患者 6 个月内再住院和死亡的预后价值。
本研究纳入了 126 例因急性心力衰竭入住 Ramathibodi 医院的前瞻性队列患者（平均年龄 69±15 岁）。在出院前 24 小时内评估 B 线和下腔静脉大小。对患者进行 6 个月的随访。
出院时的平均 B 线数量为 9±9，B 线数量较多（≥12）的患者在 6 个月内再住院的比例显著高于 B 线数量较少（<12）的患者（对数秩 χ²=7.74，P=0.004）。在单变量分析中，出院前存在≥12 条 B 线（危险比=2.15，95%置信区间=1.27-3.63）是 6 个月时发生事件的独立预测因素。
床边肺部超声检测到的出院前肺淤血可预测心力衰竭患者 6 个月时的再住院。存在非显著 B 线可识别出心力衰竭再住院风险较低的亚组。
