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首页> 外文期刊>Canadian Journal of Emergency Medicine >A lung ultrasound score for early triage of elderly patients with acute dyspnea
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A lung ultrasound score for early triage of elderly patients with acute dyspnea

机译：肺超声评分对老年急性呼吸困难患者的早期分类

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ObjectivesLung ultrasound has value in diagnosing dyspnea. The main objective of this study was to evaluate the accuracy of a modified lung ultrasound (MLUS) score to predict the severity of acute dyspnea in elderly patients.MethodsThis was an observational single-centre study including patients over age 64 admitted to the emergency department for acute dyspnea with hypoxia. Participants had an early lung ultrasound performed by a dedicated emergency physician, followed by the usual care by a team blinded to the lung ultrasound results. Patients were allocated by disposition to either a critical care (CC) group (patients who needed admission to the intensive care unit [ICU] and/or who died within 48 h) or a standard care group.ResultsAmong 137 patients analysed (mean age 79 ± 13 years, 74 [54%] women), 43 (31%) were categorized into the CC group. The time taken to obtain the MLUS was 30 ± 22 min. The area under the receiver operating characteristic curve of the MLUS for predicting the CC group was 0.97 (0.92–0.99; p & 0.01) with a cut-off set strictly above 17 for 93% sensitivity (81–99), 99% specificity (94–100), a positive predictive value of 98% (87–100), a negative predictive value of 97% (91–99), a positive likelihood ratio of 86, a negative likelihood ratio of 0.07, and a diagnostic accuracy of 97% (93–99). In a multivariate analysis, the MLUS was the only independent associated factor for the CC group.ConclusionAn early lung ultrasound score can predict the need for ICU admission and/or death within 48 hours in elderly dyspneic patients.
机译：目的肺部超声在诊断呼吸困难中具有价值。这项研究的主要目的是评估改良的肺部超声（MLUS）评分的准确性，以预测老年患者的急性呼吸困难的严重程度。方法这是一项观察性单中心研究，包括64岁以上入院急诊科的患者。急性呼吸困难伴缺氧。参与者由专门的急诊医师进行了早期的肺部超声检查，然后由对肺部超声检查结果不知情的团队进行了常规护理。通过处置将患者分配到重症监护（CC）组（需要入院重症监护病房[ICU]和/或在48小时内死亡的患者）或标准护理组。结果分析了137名患者（平均年龄79岁） ±13岁，74名[54％]妇女），43名（31％）被归为CC组。获得MLUS的时间为30±22分钟。用于预测CC组的MLUS接收器工作特性曲线下的面积为0.97（0.92-0.99; p <0.01），对于93％的敏感性（81-99），99％的特异性，临界值严格高于17 （94-100），阳性预测值为98％（87-100），阴性预测值为97％（91-99），阳性似然比为86，阴性似然比为0.07，诊断准确性97％（93–99）。在多变量分析中，MLUS是CC组的唯一独立相关因素。结论早期的肺超声检查可以预测老年呼吸困难患者在48小时内需要ICU入院和/或死亡。

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