Prognostic Value of Lung Ultrasonography in Older Nursing Home Residents Affected by COVID-19.
Nicola Veronese, Luca Gino Sbrogiò, Roberto Valle and 3 others
PMID 32883596WHAT IT FOUND
A bedside lung ultrasound score did not show a significant difference in death risk between score groups in 48 nursing home residents with COVID-19.
Do not use it alone to decide who may die.
Key findings
01In 48 residents, a lung ultrasound score of 4 or higher did not show a significant difference in death risk: 7 of 20 residents with that score died, compared with 5 of 28 with a lower score.
02The area under the curve for the lung ultrasound score was 0.603 (95% CI: 0.419-0.787) initially and 0.725 (95% CI: 0.41-0.99) after follow-up scores.
03At a score cutoff of 4 or higher, sensitivity was 58.33% and specificity was 63.89% for predicting death.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 48 residents were analysed, and the authors described the work as exploratory because the area under the curve was less than 0.70. The study did not adjust for comorbidities, polypharmacy, or treatments against COVID-19, so other factors may have influenced mortality. All scans were performed by one operator, and follow-up scans were available for only 32 of 48 participants. The confidence intervals were wide, and the score cutoff did not show a significant difference in deaths between groups. It was a single nursing home in Italy with residents who were mainly bedridden and affected by dementia, so it may not apply to other settings or patients.
The easy way to misread this
Do not conclude that lung ultrasound can be used to decide who will die. The paper's own cutoff analysis did not show a significant difference in deaths, and the authors called the study exploratory because the accuracy was below 0.70.