Prognostic value of bedside lung ultrasound score in patients admitted for Acutely Decompensated Heart Failure in the emergency.

Área: Hospitalar

FABIANA GABE BELTRAMI

Talita Zanette
Ana Lucia Martins da Costa
Regis Goulart Rosa
Felippe Leopoldo Dexheimer Neto
Juliana Cardozo Fernandes

Background: Lung ultrasound has been recognized as a promising tool in the diagnosis of acutely decompensated heart failure (ADHF). Once it can identify a pathologic increase in extra-vascular lung water, further than diagnosis it may be have prognostic meaning. This study was designed to evaluate the correlation of a bedside lung ultrasound score (LUS) in ADHF patients admitted in the emergency department (ED) and clinical outcomes. Methods: We prospectively enrolled 42 patients consecutive adult patients admitted for ADHF in the ED, from May to August 2015. Bedside lung ultrasound examination was performed in the first 24 hours after hospital admission and a LUS was performed as previously validated. Results: The median lengh of stay (LOS) was 8 days and hospital`s mortality 7%. The median LUS was higher in the group of patients that needed ventilatory support (14 vs. 10, p = 0.02). Patients that developed the composite outcome of death, need for ICU tranfer or readmission 30 days after discharge had also higher LUS (13 vs. 9, p = 0.02). In the multivariate Possion regression, LUS by each point was associated with higher LOS (RR = 1.04, IC 95% 1.02 - 1.05, p < 0.001). Conclusions: LUS performed in the ED was able to identify the severity of ADHF and may be useful as prognostic marker in this setting.