SERAFINO MANSUETO AWARD | Bedside lung ultrasound in the diagnosis of community acquired pneumonia in 569 elderly patients in an Internal Medicine department
Year: 2025
Type: article
Study design: Observational Study
Abstract: Premises and Purpose of the study: Aim of the study is to evaluate the clinical performance and utility of Bedside Lung ultrasound in diagnosis of community acquired pneumonia (CAP) in elderly patients. Materials and Methods: 569 patients were studied from January 2021 to 2025; final diagnosis: 77 acute bronchitis/COPD (mean age: 79,1Y); pneumonia: 492 (mean age: 79,4Y); Clinical Diagnosis (CD) (based on patient history, physical examination and laboratory tests), chest x-ray (CXR) and lung ultrasound (LUS) were evaluated. Corresponding Sensitivity, specificity, overall diagnostic accuracy (ODA) (and AUROC) of were calculated. Results: CD: True+: 135; true-: 59; False+: 18; False-: 357 (SENS: 27%; SPEC: 76,6%; ODA: 9,3% PPV: 88,2% NPV: 14,2%) (AU-ROC: 0,5203 SEAUC=0,035); CXR: True+: 244; true-:43; False-: 34; False-: 248 (SENS: 49,6; SPEC: 55,8%; ODA: 17%; PPV: 87,8%; NPV: 14,8%) (AU-ROC: 0,5272 SEAUC=0,0349); LUS: True+: 464; True-: 58; False+: 19; False-: 28 (SENS: 94,3%; SPEC: 75,3%; ODA: 90,9%; PPV: 96,1%; NPV: 67,4%) (AU-ROC: 0,8175 SEAUC=0,0202); pneumonia was diagnosed: by CRX and LUS in 129/492 (26,21%); only by LUS in 335/492 (68%) (in 28/335 -8,3%- Pneumonia diagnosis was clinically unexpected); only by CT in 28/492 (5,6%) cases. Conclusions: CD of CAP in the elderly is difficult and unsatisfactory; the radiological one is obtainable in about half of the cases; Bedside Lus diagnoses pneumonia correctly in 94.3% (and alone in 68%) of elderly people; It has excellent sensitivity (94.3%) but a non -optimal specificity (75.3%); In 8% of cases CAP diagnosis was unexpected.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413686436