Lung ultrasound in the diagnosis of stroke-associated pneumonia

Chiara Busti, Giancarlo Agnelli, Michele Duranti, Cristina Orlandi, Maura Marcucci, Maurizio Paciaroni

Research output: Contribution to journalArticle

Abstract

Pneumonia is a common complication in stroke patients; it is associated with an adverse outcome, prolonged hospital stay and increased health costs. The aim of this study was to assess the ability of lung ultrasound to rule in or rule out pneumonia in patients with stroke. Patients with ischemic or hemorrhagic stroke were included in the study if they had a clinical suspicion of pneumonia. Lung ultrasound imaging and chest X-ray studies were performed within 24 h from the onset of symptoms of pneumonia; the sonographer and radiologists were unaware of the chest X-ray study and ultrasound imaging results, respectively. In case of discordant results, lung computed tomography (CT) was performed if a definitive diagnosis was required to optimize clinical management. Seventy patients were included in the study. Among 24 patients with unilaterally positive chest X-ray studies, the ultrasound imaging was unilaterally positive in 19 cases (79.2 %), bilaterally positive in 3 cases (12.5 %) and negative in 2 cases (8.3 %). Among 44 patients with negative chest X-ray studies, ultrasound imaging was unilaterally positive in 17 cases (38.6 %), bilaterally positive in 2 cases (4.6 %), negative in 19 cases (43.2 %) and non-conclusive in 6 cases (13.6 %). A lung CT scan was performed in 9 of the 21 discordant cases, and it always confirmed the ultrasound imaging results. Ultrasound imaging and chest X-ray studies were concordant in 42 out of 63 cases, 66.7 % (Pearson χ2 = 11.97, p = 0.001). In conclusions, this study shows the utility of LUS imaging to rule in or rule out pneumonia in patients with stroke. We believe that lung ultrasound imaging can help clinicians in the diagnosis of stroke-associated pneumonia.

Original languageEnglish
Pages (from-to)173-178
Number of pages6
JournalInternal and Emergency Medicine
Volume9
Issue number2
DOIs
Publication statusPublished - Mar 2014

Fingerprint

Ultrasonography
Pneumonia
Stroke
Lung
Thorax
X-Rays
Tomography
Health Care Costs
Length of Stay

Keywords

  • Chest X-ray
  • Lung ultrasound
  • Stroke pneumonia

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine
  • Medicine(all)

Cite this

Lung ultrasound in the diagnosis of stroke-associated pneumonia. / Busti, Chiara; Agnelli, Giancarlo; Duranti, Michele; Orlandi, Cristina; Marcucci, Maura; Paciaroni, Maurizio.

In: Internal and Emergency Medicine, Vol. 9, No. 2, 03.2014, p. 173-178.

Research output: Contribution to journalArticle

Busti, C, Agnelli, G, Duranti, M, Orlandi, C, Marcucci, M & Paciaroni, M 2014, 'Lung ultrasound in the diagnosis of stroke-associated pneumonia', Internal and Emergency Medicine, vol. 9, no. 2, pp. 173-178. https://doi.org/10.1007/s11739-012-0832-7
Busti, Chiara ; Agnelli, Giancarlo ; Duranti, Michele ; Orlandi, Cristina ; Marcucci, Maura ; Paciaroni, Maurizio. / Lung ultrasound in the diagnosis of stroke-associated pneumonia. In: Internal and Emergency Medicine. 2014 ; Vol. 9, No. 2. pp. 173-178.
@article{94ba35296af54be99df0a06664521c5d,
title = "Lung ultrasound in the diagnosis of stroke-associated pneumonia",
abstract = "Pneumonia is a common complication in stroke patients; it is associated with an adverse outcome, prolonged hospital stay and increased health costs. The aim of this study was to assess the ability of lung ultrasound to rule in or rule out pneumonia in patients with stroke. Patients with ischemic or hemorrhagic stroke were included in the study if they had a clinical suspicion of pneumonia. Lung ultrasound imaging and chest X-ray studies were performed within 24 h from the onset of symptoms of pneumonia; the sonographer and radiologists were unaware of the chest X-ray study and ultrasound imaging results, respectively. In case of discordant results, lung computed tomography (CT) was performed if a definitive diagnosis was required to optimize clinical management. Seventy patients were included in the study. Among 24 patients with unilaterally positive chest X-ray studies, the ultrasound imaging was unilaterally positive in 19 cases (79.2 {\%}), bilaterally positive in 3 cases (12.5 {\%}) and negative in 2 cases (8.3 {\%}). Among 44 patients with negative chest X-ray studies, ultrasound imaging was unilaterally positive in 17 cases (38.6 {\%}), bilaterally positive in 2 cases (4.6 {\%}), negative in 19 cases (43.2 {\%}) and non-conclusive in 6 cases (13.6 {\%}). A lung CT scan was performed in 9 of the 21 discordant cases, and it always confirmed the ultrasound imaging results. Ultrasound imaging and chest X-ray studies were concordant in 42 out of 63 cases, 66.7 {\%} (Pearson χ2 = 11.97, p = 0.001). In conclusions, this study shows the utility of LUS imaging to rule in or rule out pneumonia in patients with stroke. We believe that lung ultrasound imaging can help clinicians in the diagnosis of stroke-associated pneumonia.",
keywords = "Chest X-ray, Lung ultrasound, Stroke pneumonia",
author = "Chiara Busti and Giancarlo Agnelli and Michele Duranti and Cristina Orlandi and Maura Marcucci and Maurizio Paciaroni",
year = "2014",
month = "3",
doi = "10.1007/s11739-012-0832-7",
language = "English",
volume = "9",
pages = "173--178",
journal = "Internal and Emergency Medicine",
issn = "1828-0447",
publisher = "Springer-Verlag Italia s.r.l.",
number = "2",

}

TY - JOUR

T1 - Lung ultrasound in the diagnosis of stroke-associated pneumonia

AU - Busti, Chiara

AU - Agnelli, Giancarlo

AU - Duranti, Michele

AU - Orlandi, Cristina

AU - Marcucci, Maura

AU - Paciaroni, Maurizio

PY - 2014/3

Y1 - 2014/3

N2 - Pneumonia is a common complication in stroke patients; it is associated with an adverse outcome, prolonged hospital stay and increased health costs. The aim of this study was to assess the ability of lung ultrasound to rule in or rule out pneumonia in patients with stroke. Patients with ischemic or hemorrhagic stroke were included in the study if they had a clinical suspicion of pneumonia. Lung ultrasound imaging and chest X-ray studies were performed within 24 h from the onset of symptoms of pneumonia; the sonographer and radiologists were unaware of the chest X-ray study and ultrasound imaging results, respectively. In case of discordant results, lung computed tomography (CT) was performed if a definitive diagnosis was required to optimize clinical management. Seventy patients were included in the study. Among 24 patients with unilaterally positive chest X-ray studies, the ultrasound imaging was unilaterally positive in 19 cases (79.2 %), bilaterally positive in 3 cases (12.5 %) and negative in 2 cases (8.3 %). Among 44 patients with negative chest X-ray studies, ultrasound imaging was unilaterally positive in 17 cases (38.6 %), bilaterally positive in 2 cases (4.6 %), negative in 19 cases (43.2 %) and non-conclusive in 6 cases (13.6 %). A lung CT scan was performed in 9 of the 21 discordant cases, and it always confirmed the ultrasound imaging results. Ultrasound imaging and chest X-ray studies were concordant in 42 out of 63 cases, 66.7 % (Pearson χ2 = 11.97, p = 0.001). In conclusions, this study shows the utility of LUS imaging to rule in or rule out pneumonia in patients with stroke. We believe that lung ultrasound imaging can help clinicians in the diagnosis of stroke-associated pneumonia.

AB - Pneumonia is a common complication in stroke patients; it is associated with an adverse outcome, prolonged hospital stay and increased health costs. The aim of this study was to assess the ability of lung ultrasound to rule in or rule out pneumonia in patients with stroke. Patients with ischemic or hemorrhagic stroke were included in the study if they had a clinical suspicion of pneumonia. Lung ultrasound imaging and chest X-ray studies were performed within 24 h from the onset of symptoms of pneumonia; the sonographer and radiologists were unaware of the chest X-ray study and ultrasound imaging results, respectively. In case of discordant results, lung computed tomography (CT) was performed if a definitive diagnosis was required to optimize clinical management. Seventy patients were included in the study. Among 24 patients with unilaterally positive chest X-ray studies, the ultrasound imaging was unilaterally positive in 19 cases (79.2 %), bilaterally positive in 3 cases (12.5 %) and negative in 2 cases (8.3 %). Among 44 patients with negative chest X-ray studies, ultrasound imaging was unilaterally positive in 17 cases (38.6 %), bilaterally positive in 2 cases (4.6 %), negative in 19 cases (43.2 %) and non-conclusive in 6 cases (13.6 %). A lung CT scan was performed in 9 of the 21 discordant cases, and it always confirmed the ultrasound imaging results. Ultrasound imaging and chest X-ray studies were concordant in 42 out of 63 cases, 66.7 % (Pearson χ2 = 11.97, p = 0.001). In conclusions, this study shows the utility of LUS imaging to rule in or rule out pneumonia in patients with stroke. We believe that lung ultrasound imaging can help clinicians in the diagnosis of stroke-associated pneumonia.

KW - Chest X-ray

KW - Lung ultrasound

KW - Stroke pneumonia

UR - http://www.scopus.com/inward/record.url?scp=84894441537&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84894441537&partnerID=8YFLogxK

U2 - 10.1007/s11739-012-0832-7

DO - 10.1007/s11739-012-0832-7

M3 - Article

C2 - 22847729

AN - SCOPUS:84894441537

VL - 9

SP - 173

EP - 178

JO - Internal and Emergency Medicine

JF - Internal and Emergency Medicine

SN - 1828-0447

IS - 2

ER -