Title : Seeing is believing: Analysis of the influence of congestion determined by lung ultrasound on 30-day mortality in patients with heart failure- step by step study
Abstract:
The symptoms shown by frail patients with heart failure (HF) are sometimes different and the most common symptoms may be absent, delaying the diagnosis and finding patients with more severe HF. The use of lung ultrasound in these patients could help to objectify real congestion.
Observational, multicenter and prospective study carried out in the Cardiology and Internal Medicine Service of 28 hospitals in Spain. All patients admitted within the first 48 hours of admission with a main diagnosis of heart failure and with NT-ProBNP greater than 300 pg/ml on admission were included. A binary regression was performed to study the influence of congestion variables determined by lung ultrasound and chest x-ray on 30-day mortality. To calculate the sample size, a power of 80% and an alpha error of 0.05 were used up to N= 778.
The main finding described in this study is the high fragility that we found in the patient with HF 75.8% n=583. The results obtained after a binary logistic regression to study the influence of the most frequent and significant comorbidities in the patient with an SPPB score <5 on 30-day mortality show that the presence of pleural effusion present in the lung ultrasound at Admission increases the patient's death by 8.71 times at 30 days of follow-up (p=0.03).
The use of lung ultrasound performed systematically in these patients could help establish a diagnosis and initiate early treatment.
Audience Take Away:
- Healthcare professionals, especially those in cardiology and internal medicine, could benefit from this study when faced with frail patients with heart failure
- The use of lung ultrasound to image actual congestion in these patients could aid in early diagnosis and initiation of appropriate treatment, potentially improving clinical management and patient outcomes
- Other teachers and academics could use this study as a basis for expanding their own research or as teaching materials in courses related to heart failure, lung ultrasound, and the management of frail patients. This would contribute to the advancement of knowledge in the field and enrich the education of students
- The systematic incorporation of lung ultrasound in the evaluation of patients with heart failure could simplify and make the diagnosis and treatment process more efficient
- The use of lung ultrasound in the frail patient with HF would provide additional information that would help physicians make more informed clinical decisions and design more precise treatment plans
- In addition to those mentioned above, this study could also encourage additional research into the use of lung ultrasound in patients with heart failure, promote collaboration between different medical centers in Spain and beyond, and increase awareness about the importance of screening. exhaustive study of fragile patients with this disease
