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Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting

BACKGROUND: Lung ultrasound is an effective tool for diagnosing pneumonia in developed countries. Diagnostic accuracy in resource-limited countries where pneumonia is the leading cause of death is unknown. The objective of this study was to evaluate the sensitivity of bedside lung ultrasound compare...

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Autores principales: Amatya, Yogendra, Rupp, Jordan, Russell, Frances M., Saunders, Jason, Bales, Brian, House, Darlene R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845910/
https://www.ncbi.nlm.nih.gov/pubmed/29527652
http://dx.doi.org/10.1186/s12245-018-0170-2
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author Amatya, Yogendra
Rupp, Jordan
Russell, Frances M.
Saunders, Jason
Bales, Brian
House, Darlene R.
author_facet Amatya, Yogendra
Rupp, Jordan
Russell, Frances M.
Saunders, Jason
Bales, Brian
House, Darlene R.
author_sort Amatya, Yogendra
collection PubMed
description BACKGROUND: Lung ultrasound is an effective tool for diagnosing pneumonia in developed countries. Diagnostic accuracy in resource-limited countries where pneumonia is the leading cause of death is unknown. The objective of this study was to evaluate the sensitivity of bedside lung ultrasound compared to chest X-ray for pneumonia in adults presenting for emergency care in a low-income country. METHODS: Patients presenting to the emergency department with suspected pneumonia were evaluated with bedside lung ultrasound, single posterioranterior chest radiograph, and computed tomography (CT). Using CT as the gold standard, the sensitivity of lung ultrasound was compared to chest X-ray for the diagnosis of pneumonia using McNemar’s test for paired samples. Diagnostic characteristics for each test were calculated. RESULTS: Of 62 patients included in the study, 44 (71%) were diagnosed with pneumonia by CT. Lung ultrasound demonstrated a sensitivity of 91% compared to chest X-ray which had a sensitivity of 73% (p = 0.01). Specificity of lung ultrasound and chest X-ray were 61 and 50% respectively. CONCLUSIONS: Bedside lung ultrasound demonstrated better sensitivity than chest X-ray for the diagnosis of pneumonia in Nepal. TRIAL REGISTRATION: ClinicalTrials.gov, registration number NCT02949141. Registered 31 October 2016.
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spelling pubmed-58459102018-03-20 Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting Amatya, Yogendra Rupp, Jordan Russell, Frances M. Saunders, Jason Bales, Brian House, Darlene R. Int J Emerg Med Original Research BACKGROUND: Lung ultrasound is an effective tool for diagnosing pneumonia in developed countries. Diagnostic accuracy in resource-limited countries where pneumonia is the leading cause of death is unknown. The objective of this study was to evaluate the sensitivity of bedside lung ultrasound compared to chest X-ray for pneumonia in adults presenting for emergency care in a low-income country. METHODS: Patients presenting to the emergency department with suspected pneumonia were evaluated with bedside lung ultrasound, single posterioranterior chest radiograph, and computed tomography (CT). Using CT as the gold standard, the sensitivity of lung ultrasound was compared to chest X-ray for the diagnosis of pneumonia using McNemar’s test for paired samples. Diagnostic characteristics for each test were calculated. RESULTS: Of 62 patients included in the study, 44 (71%) were diagnosed with pneumonia by CT. Lung ultrasound demonstrated a sensitivity of 91% compared to chest X-ray which had a sensitivity of 73% (p = 0.01). Specificity of lung ultrasound and chest X-ray were 61 and 50% respectively. CONCLUSIONS: Bedside lung ultrasound demonstrated better sensitivity than chest X-ray for the diagnosis of pneumonia in Nepal. TRIAL REGISTRATION: ClinicalTrials.gov, registration number NCT02949141. Registered 31 October 2016. Springer Berlin Heidelberg 2018-03-12 /pmc/articles/PMC5845910/ /pubmed/29527652 http://dx.doi.org/10.1186/s12245-018-0170-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Amatya, Yogendra
Rupp, Jordan
Russell, Frances M.
Saunders, Jason
Bales, Brian
House, Darlene R.
Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting
title Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting
title_full Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting
title_fullStr Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting
title_full_unstemmed Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting
title_short Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting
title_sort diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845910/
https://www.ncbi.nlm.nih.gov/pubmed/29527652
http://dx.doi.org/10.1186/s12245-018-0170-2
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