Chiara Cogliati1, Giovanni Casazza2, Elisa Ceriani3, Daniela Torzillo4, Stefano Furlotti5, Ilaria Bossi6, Tarcisio Vago7, Giorgio Costantino8, Nicola Montano9. 1. Department of Internal Medicine, L.Sacco Hospital University of Milan, Italy. Electronic address: chiaracogliati@fastwebnet.it. 2. Department of Biomedical and Clinical Sciences, University of Milan, Italy. Electronic address: giovanni.casazza@unimi.it. 3. Department of Internal Medicine, Ca Granda Foundation IRCCS, Ospedale Maggiore Policlinico, Department of Health and Community Sciences, University of Milan, Italy. Electronic address: elisa.ceriani@live.com. 4. Department of Internal Medicine, L.Sacco Hospital University of Milan, Italy. Electronic address: danielatorzillo@alice.it. 5. Department of Internal Medicine, L.Sacco Hospital University of Milan, Italy. Electronic address: s.furlotti@gmail.com. 6. Emergency Medicine, L.Sacco Hospital University of Milan, Italy. Electronic address: ilariaiaia@yahoo.com. 7. Clinical Endocrinology Laboratory, L.Sacco Hospital University of Milan, Italy. Electronic address: vago.tarcisio@hsacco.it. 8. Department of Internal Medicine, Ca Granda Foundation IRCCS, Ospedale Maggiore Policlinico, Department of Health and Community Sciences, University of Milan, Italy. Electronic address: giorgio.costantino@unimi.it. 9. Department of Internal Medicine, Ca Granda Foundation IRCCS, Ospedale Maggiore Policlinico, Department of Health and Community Sciences, University of Milan, Italy. Electronic address: nicola.montano@unimi.it.
Abstract
BACKGROUND: Heart failure (HF) is the leading cause of hospitalization for patients older than 65years, with a 30-day readmission rate of 20-25%. Although several markers have been evaluated to stratify timing of follow-up after an acute decompensation is mostly based on clinical judgment. Lung ultrasound (LUS) has been demonstrated to be a valid tool for the assessment and monitoring of pulmonary congestion. Aim of our study was to evaluate if LUS performed in HF patients at discharge could predict 100-day hospital readmission or death. METHODS: One-hundred fifty patients were enrolled. The anterolateral chest was scanned to evaluate the presence of B-lines. A sonographic score was calculated attributing 1 to each positive (≥3 B-lines) sector. Clinical, biochemical and echocardiographic data were recorded. A Cox proportional hazard regression analysis was performed to evaluate the association between variables and 100-day events. RESULTS: Follow-up was obtained in 149 patients. Thirty-four events were recorded. Sonographic score was significantly associated with events (HR 1.19; CI 1.05 to 1.34; p=0.005). On average, the increase of 1 point in the sonographic score was associated with an increase of approximately 24% in the risk of event within 100days. At multivariate analysis NTproBNP remained the only independent prognostic factor. CONCLUSIONS: We confirmed that B-lines at discharge are a prognostic marker for hospital readmission and death at 100days in HF patients. Nevertheless, further randomized clinical studies are needed to definitely support the routine use of LUS in the clinical management of HF patients, in combination or not with NT-proBNP.
BACKGROUND:Heart failure (HF) is the leading cause of hospitalization for patients older than 65years, with a 30-day readmission rate of 20-25%. Although several markers have been evaluated to stratify timing of follow-up after an acute decompensation is mostly based on clinical judgment. Lung ultrasound (LUS) has been demonstrated to be a valid tool for the assessment and monitoring of pulmonary congestion. Aim of our study was to evaluate if LUS performed in HF patients at discharge could predict 100-day hospital readmission or death. METHODS: One-hundred fifty patients were enrolled. The anterolateral chest was scanned to evaluate the presence of B-lines. A sonographic score was calculated attributing 1 to each positive (≥3 B-lines) sector. Clinical, biochemical and echocardiographic data were recorded. A Cox proportional hazard regression analysis was performed to evaluate the association between variables and 100-day events. RESULTS: Follow-up was obtained in 149 patients. Thirty-four events were recorded. Sonographic score was significantly associated with events (HR 1.19; CI 1.05 to 1.34; p=0.005). On average, the increase of 1 point in the sonographic score was associated with an increase of approximately 24% in the risk of event within 100days. At multivariate analysis NTproBNP remained the only independent prognostic factor. CONCLUSIONS: We confirmed that B-lines at discharge are a prognostic marker for hospital readmission and death at 100days in HF patients. Nevertheless, further randomized clinical studies are needed to definitely support the routine use of LUS in the clinical management of HF patients, in combination or not with NT-proBNP.
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Authors: Frances M Russell; Robert R Ehrman; Robinson Ferre; Luna Gargani; Vicki Noble; Jordan Rupp; Sean P Collins; Benton Hunter; Kathleen A Lane; Phillip Levy; Xiaochun Li; Christopher O'Connor; Peter S Pang Journal: Heart Lung Date: 2018-11-15 Impact factor: 2.210
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Authors: Peter S Pang; Frances M Russell; Robert Ehrman; Rob Ferre; Luna Gargani; Phillip D Levy; Vicki Noble; Kathleen A Lane; Xiaochun Li; Sean P Collins Journal: JACC Heart Fail Date: 2021-07-07 Impact factor: 12.544