The role of transthoracic ultrasonography in predicting the outcome of community-acquired pneumonia in hospitalized children

Transthoracic ultrasound (TUS) has recently become a valuable tool in the diagnosis of community-acquired pneumonia (CAP). This study assessed the association between TUS findings and clinical outcome in children with CAP. The medical records of pediatric patients hospitalized with CAP who underwent transthoracic ultrasonography within 48 hours of admission were retrospectively reviewed. Associations between the TUS findings and patient outcome were analyzed, including intensive care unit (ICU) admission, length of hospital stay, and tube thoracotomy. The study enrolled 142 patients (median age, 60 months): 28 (19.7%) required ICU admission, 14 (9.89%) underwent tube thoracotomy, and 26 (18.3%) had a hospital stay > 9 days. Multifocal involvement seen by TUS were independently associated with ICU admission, a prolonged hospital stay, and tube thoracotomy (p = 0.0027, p = 0.02, and p = 0.0262, respectively). A pleural effusion and fluid bronchogram were independent predictors of a longer hospital stay (p = 0.003 and p = 0.006, respectively). In addition, a fluid bronchogram was an independent predictor of tube thoracotomy (p = 0.0262). CONCLUSION: TUS findings of fluid bronchogram, multifocal involvement, and pleural effusion were associated with adverse outcomes, including longer hospital stay, ICU admission, and tube thoracotomy in hospitalized CAP children. Therefore, TUS is a novel tool for prognostic stratifications of CAP in hospitalized children.