Role of chest ultrasonography in prognosis of community-acquired pneumonia

Abstract

Background: Chest ultrasonography has shown a growing interest during the last few years based on its new applications and significance of sonographic artifacts. Objectives: To assess the ability of bedside chest ultrasonography (USG) in prognosis of Community-acquired pneumonia (CAP) patients and to compare with Pneumonia severity index (PSI) score & chest radiograph(CXR ). Methods: A prospective observational study in 100 patients who got admitted with CAP, PSI scoring was determined and CXR &USG done at the time of presentation.PSI scoring, CXR & USG repeated on third day and at the time of final outcome. Results: USG showed features of consolidation in 92% patients. Dynamic air bronchogram was present in patients with sonographically detected pneumonia. Hepatisation of lung tissue detected in 30% and irregular & serrated margins in 43% of patients. Pleural effusion was evident in 29% of patients by USG, but only 13% by CXR. Disease remission was also demonstrated sonographically. The proportion of patients with an air bronchogram decreased to 39% of patients during discharge.Correlation between USG, CXR and PSI score were analysed using Spearman9s rho rank correlation (r). A significant correlation between USG and PSI score was found (on day1 r= 0.35, on day3 r= 0.43, & on final day r= 0.25) which were significant at 0.01 level. A significant correlation was also found between USG and CXR (on day1 r=0.81, on day3 r=0.81 & on final day r=0.74) which were significant at 0.01 level. Conclusion: This study supports the routine use of chest-ultrasound in prognostic evaluation of CAP, as it is bedside real time, reliable, rapid, non-invasive technique and it help for rapid therapeutic decision.