Emergency Care Journal · Published 2026-07-20 · DOI 10.4081/ecj.2026.14986
Emanuele Pivetta, Alessio Prota, Paolo Bima, Federico Grosso, Matteo Oddi, Giulia Silvestri, Barbara Casanova, Eleonora de Villa, Eriola Haxhiraj, Enrico Lupia, Fulvio Morello, Peiman Nazerian
In patients presenting to the Emergency Department (ED) with acute respiratory symptoms or suspected infection, Lung Ultrasound (LUS) may serve as a valuable diagnostic tool. Its use and clinical applicability markedly increased since the SARS-CoV-2 pandemic. The aim of this study was to evaluate whether LUS can predict 30-day mortality or Intensive Care Unit (ICU) admission in patients presenting to the ED and to develop a prognostic model. We conducted a bicentric observational cohort in two Italian EDs. Two scores were analyzed, the overall LUS score and the anterolateral LUS score. Multivariable logistic regression models were developed, and their performance was assessed using the area under the receiver operating characteristic curve (Area Under the Curve, AUC) and validated with concordance indices (C-indexes). Four hundred and thirty-four patients were enrolled. The median time from symptom onset to ED presentation was 4 days (IQR 6). The primary final diagnosis was SARS-COV2 infection in 32% of cases, other respiratory diseases in 15%, heart failure in 9%. The composite outcome occurred in 68 patients (15.7%). The empirically estimated AUC of the LUS score was 67%. A prognostic model including age, overall LUS score, time from symptom onset, history of diabetes, chronic kidney disease, and cancer within the previous 5 years showed a C-index of 70.8%. This study suggests that, in patients presenting to the ED with respiratory symptoms, the LUS score may have a prognostic value regardless of the final diagnosis established at the end of the diagnostic work-up performed in the ED.
Abstract from DOAJ. Public domain (CC0 1.0).
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Pivetta, E., Prota, A., Bima, P., et al. (2026). Prognostic performance of lung ultrasound score in patients presenting to the emergency department with respiratory complaints or suspected infection independent of final diagnosis. Emergency Care Journal. https://doi.org/10.4081/ecj.2026.14986