Diagnostic value of routine usage of lung ultrasound in patients admitted to chest diseases outpatient clinic.

Abstract

Introduction: Many studies have shown that the diagnostic value of lung ultrasound is much better than chest radiography in selected patients in emergency departments, intensive care units and inpatient clinics. However, there is insufficient data on the routine use of lung ultrasonography (LUS) in chest diseases outpatient clinics. The main aim of this study was to determine the diagnostic value of routine use of AUS in outpatients.

Materials and methods: One hundred and twenty-nine patients were included in the study. Lung ultrasound was performed by a pulmonologist on the same day as chest radiography (CXR), unaware of the patient's clinical and radiologic information. Chest radiographs of the patients were evaluated by two independent experts after patient recruitment was completed. The clinical final diagnosis (CFD), which was accepted as the reference standard, was obtained from hospital automation records.

Result: Patients were divided into two groups as those with pulmonary pathology (n= 74) and those without pulmonary pathology (n= 55) according to CFD. The sensitivity and specificity values of LUS and CXR were 48.05% and 50.64% and 78.85% and 84.62%, respectively. The rates of detection of pulmonary disease by LUS and CXR were similar (McNemar test, p< 0.05). There was moderate agreement between the two tests in assessing the presence of pulmonary pathology (kappa= 0.484, p< 0.05). Female sex and obesity negatively affected the diagnostic accuracy of LUS (p< 0.05), whereas age and symptom duration had no effect (p< 0.05). Mean LUS duration was 8.02 minutes.

Conclusions: The study demonstrated that LUS can contribute as a preliminary diagnostic tool with or without CXR in outpatient settings. Especially in situations where chest radiography is unavailable or contraindicated, such as pregnancy, LUS can safely contribute to the diagnosis of lung disease.