Lung ultrasound for diagnosis of pneumonia in emergency department.
Lung ultrasound (LUS) in the emergency department (ED) has shown a significant role in the diagnostic workup of pulmonary edema, pneumothorax and pleural effusions. The aim of this study is to assess the reliability of LUS for the diagnosis of acute pneumonia compared to chest X-ray (CXR) study. The study was conducted from September 2013 to March 2015. 107 patients were admitted to the ED with a clinical appearance of pneumonia. All the patients underwent a CXR study, read by a radiologist, and an LUS, performed by a trained ED physician on duty. Among the 105 patients, 68 were given a final diagnosis of pneumonia. We found a sensitivity of 0.985 and a specificity of 0.649 for LUS, and a sensitivity of 0.735 and specificity of 0.595 for CXR. The positive predictive value for LUS was 0.838 against 0.7 for CXR. The negative predictive value of LUS was 0.960 versus 0.550 for CXR. This study has shown sensitivity, positive predictive value and negative predictive value of LUS compared to the CXR study for the diagnosis of acute pneumonia. These results suggest the use of bedside thoracic US first-line diagnostic tool in patients with suspected pneumonia.
Emergency department, Cardarelli Hospital, Neaples, Italy. antoniopag@fastwebnet.it.
Antonio
A
Pagano
Emergency department, San Paolo Hospital, Neaples, Italy.
Fabio Giuliano
FG
Numis
Emergency department, Cardarelli Hospital, Neaples, Italy.
Giuseppe
G
Visone
Emergency department, San Paolo Hospital, Neaples, Italy.
Concetta
C
Pirozzi
Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
Mario
M
Masarone
Emergency department, Cardarelli Hospital, Neaples, Italy.
Marinella
M
Olibet
Emergency department, Cardarelli Hospital, Neaples, Italy.
Rodolfo
R
Nasti
Emergency department, San Paolo Hospital, Neaples, Italy.
Fernando
F
Schiraldi
Emergency department, Cardarelli Hospital, Neaples, Italy.
Fiorella
F
Paladino
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis; D011014:Pneumonia / Q000175:diagnosis* / Q000503:physiopathology*; D011030:Pneumothorax / Q000175:diagnosis; D019095:Point-of-Care Systems / Q000706:statistics & numerical data; D011654:Pulmonary Edema / Q000175:diagnosis; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*
Chest X-ray; Lung ultrasound; Pneumonia