Kardaş Hakan, Bingöl Tanriverdi Tuğba, Erdoğan Muhammet Hanifi, Güra Çelik Melek
Department of Anesthesiology and Reanimation, University of Health Sciences, Mehmet Akif İnan Research and Training Hospital Şanliurfa, Turkey.
Department of Anesthesiology and Reanimation, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
Medicine (Baltimore). 2025 May 2;104(18):e42277. doi: 10.1097/MD.0000000000042277.
Lung ultrasound (LUS) is a noninvasive, easily repeatable, and radiation-free technique that can be applied at the bedside and is used increasingly often in patient management. This study aims to examine the relationship between the mortality of patients with COVID-19 pneumonia followed in the intensive care unit and their LUS scores obtained by evaluating different areas of the thorax and to reveal the prognostic value of this method. Fifty patients diagnosed with COVID-19 by PCR tests and followed in our intensive care unit were included in this study. The LUS scores were obtained within 24 hours of the patients' hospitalization. The patients' demographic data, APACHE II and SOFA scores, laboratory data, and survival status were retrospectively reviewed. Comparisons were made according to 28-day mortality. The mortality rate was found to be 31 (62%) among all patients included in the study. The LUS scores of the patients who died were statistically significantly higher than those of patients who survived (30.77 ± 4.31 vs 24.21 ± 5.4, P = .001). The APACHE II (P = .001) and SOFA scores (P < .001) and lactate (P = .020) and ferritin (P = .005) levels of the patients who died were also significantly higher. In correlation analysis, LUS scores were positively correlated with APACHE II (R = 0.379, P = .007) and SOFA (R = 0.457, P = .001) scores, while they were negatively correlated with PaO2 (r = -0.483, P = .001) and PaO2/FiO2 (r = -0.297, P = .036). ROC curve analysis revealed that LUS scores of ≥ 30 predicted mortality with 80.65% sensitivity and 84.21% specificity (AUC: 0.836, P = .001). The likelihood of observing a LUS score of ≥ 30 in the patients who died was 22.222 times higher compared to surviving patients (odds ratio for LUS score: 22.222, 95% confidence interval: 4.854-101.741). We determined in this study that LUS scores successfully predicted the prognosis of COVID-19 patients in the intensive care unit. Therefore, the LUS score can provide significant information to clinicians for patient management and the determination of the degree of lung involvement.
肺部超声（LUS）是一种无创、易于重复且无辐射的技术，可在床边应用，并且在患者管理中使用得越来越频繁。本研究旨在探讨在重症监护病房接受治疗的新型冠状病毒肺炎（COVID-19）患者的死亡率与通过评估胸部不同区域获得的LUS评分之间的关系，并揭示该方法的预后价值。本研究纳入了50例经聚合酶链反应（PCR）检测确诊为COVID-19并在我们重症监护病房接受治疗的患者。LUS评分在患者住院24小时内获得。回顾性分析患者的人口统计学数据、急性生理与慢性健康状况评分系统II（APACHE II）和序贯器官衰竭评估（SOFA）评分、实验室数据及生存状态。根据28天死亡率进行比较。研究纳入的所有患者中，死亡率为31例（62%）。死亡患者的LUS评分在统计学上显著高于存活患者（30.77±4.31 vs 24.21±5.4，P = 0.001）。死亡患者的APACHE II评分（P = 0.001）、SOFA评分（P < 0.001）以及乳酸水平（P = 0.020）和铁蛋白水平（P = 0.005）也显著更高。在相关性分析中，LUS评分与APACHE II评分（R = 0.379，P = 0.007）和SOFA评分（R = 0.457，P = 0.001）呈正相关，而与动脉血氧分压（PaO2）（r = -0.483，P = 0.001）和氧合指数（PaO2/FiO2）（r = -0.297，P = 0.036）呈负相关。受试者工作特征（ROC）曲线分析显示，LUS评分≥30预测死亡率的敏感度为80.65%，特异度为84.21%（曲线下面积：0.836，P = 0.001）。死亡患者中观察到LUS评分≥30的可能性是存活患者的22.222倍（LUS评分的比值比：22.222，95%置信区间：4.854 - 101.741）。我们在本研究中确定，LUS评分成功预测了重症监护病房中COVID-19患者的预后。因此，LUS评分可为临床医生进行患者管理和确定肺部受累程度提供重要信息。
