Lung ultrasound and prediction of mortality in patients with severe community-acquired pneumonia
Keywords:
artificial breathing, diagnostic imaging, mortality, pneumonia, ultrasonographyAbstract
Introduction: Lung ultrasound is presented as an alternative diagnostic technique used in decision making at the point of care.
Objective: To identify pulmonary ultrasound findings that constitute prognostic factors for mortality in patients diagnosed with severe community-acquired pneumonia treated with invasive ventilation.
Methods: An analytical, observational, case-control study was conducted from January 1, 2019, to October 30, 2023, at the Orlando Pantoja Tamayo General Teaching Hospital. A sample of 240 patients (80 cases and 160 controls) was selected by simple random sampling. A multivariate analysis was performed with a binary logistic regression model, with backward stepwise selection with likelihood ratio to assess whether independent variables contribute to mortality. Discharge status was considered as the dependent variable, and bilateral pleural effusion, bilateral thickened pleura, and pulmonary aeration scale were considered as independent variables.
Results: bilateral pleura effusion and bilateral thickened pleura was present in 18.3 % and 35.4 % of patients; with a median for the pulmonary aeration scale of 18 points. The identified prognostic factors for mortality were the presence of bilateral pleural effusion with an odds ratio (OR)=5.1 and the pulmonary aeration scale ≥20 points with an OR=3.6.
Conclusions: It is concluded that the presence of bilateral pleural effusion and a pulmonary aeration score ≥20 points are prognostic factors for mortality.
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Copyright (c) 2025 Luis Fong Pantoja, Niger Guzmán Pérez, Francisco Alberto Sánchez Licea, Elizabeth Bárbara Dieguez Matamoros, María Elena Suárez Bazan
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