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肺部超声作为外科患者筛查 SARS-CoV-2 感染的工具。

Lung ultrasound as a screening tool for SARS-CoV-2 infection in surgical patients.

机构信息

Surgery Department, Fundación Valle del Lili, Cali, Colombia.

Department of Emergency Medicine, Fundación Valle del Lili, Cali, Colombia.

出版信息

J Clin Ultrasound. 2022 Nov;50(9):1271-1278. doi: 10.1002/jcu.23358. Epub 2022 Oct 6.

Abstract

PURPOSE

To evaluate the diagnostic performance of lung ultrasound (LUS) in screening for SARS-CoV-2 infection in patients requiring surgery.

METHODS

Patients underwent a LUS protocol that included a scoring system for screening COVID-19 pneumonia as well as RT-PCR test for SARS-CoV-2. The receiver operator characteristic (ROC) curve was determined for the relationship between LUS score and PCR test results for COVID-19. The optimal threshold for the best discrimination between non-COVID-19 patients and COVID-19 patients was calculated.

RESULTS

Among 203 patients enrolled (mean age 48 years; 82 males), 8.3% were COVID-19-positive; 4.9% were diagnosed via the initial RT-PCR test. Of the patients diagnosed with SARS-CoV-2, 64.7% required in-hospital management and 17.6% died. The most common ultrasound findings were B lines (19.7%) and a thickened pleura (19.2%). The AUC of the ROC curve of the relationship of LUS score with a cutoff value >8 versus RT-PCR test for the assessment of SARS-CoV-2 pneumonia was 0.75 (95% CI 0.61-0.89; sensitivity 52.9%; specificity 91%; LR (+) 6.15, LR (-) 0.51).

CONCLUSION

The LUS score in surgical patients is not a useful tool for screening patients with potential COVID-19 infection. LUS score shows a high specificity with a cut-off value of 8.

摘要

目的

评估肺部超声(LUS)在筛查需要手术的 SARS-CoV-2 感染患者中的诊断性能。

方法

患者接受了 LUS 方案,其中包括用于筛查 COVID-19 肺炎的评分系统以及 SARS-CoV-2 的 RT-PCR 检测。确定了 LUS 评分与 COVID-19 PCR 检测结果之间的关系的受试者工作特征(ROC)曲线。计算了区分非 COVID-19 患者和 COVID-19 患者的最佳阈值。

结果

在纳入的 203 名患者中(平均年龄 48 岁;男性 82 名),8.3%为 COVID-19 阳性;4.9%通过初始 RT-PCR 检测确诊。在确诊 SARS-CoV-2 的患者中,64.7%需要住院治疗,17.6%死亡。最常见的超声表现是 B 线(19.7%)和胸膜增厚(19.2%)。LUS 评分与 RT-PCR 检测 SARS-CoV-2 肺炎的截断值>8 之间关系的 ROC 曲线的 AUC 为 0.75(95%CI 0.61-0.89;敏感性 52.9%;特异性 91%;LR(+)6.15,LR(-)0.51)。

结论

外科患者的 LUS 评分不是筛查潜在 COVID-19 感染患者的有用工具。LUS 评分显示出较高的特异性,截断值为 8。

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