Acil Servise Nefes Darlığı ile Başvuran Hastalarda Bir Ayırıcı Tanı Aracı Olarak Yatakbaşı Ultrasonografik Değerlendirme

Abstract

Dyspnea is a common complaint among the patients admitted to emergency department. 124 patients who admitted to Hacettepe University, Adult Emergency Department with the complaint of dyspnea within April 2013-October 2013 are included in the prospective, cross-sectional, descriptive study. During the first 24 hours, evaluations of lung ultrasonography appropriate to Bedside Lung Ultrasound in Emergency (BLUE) protocol is done. It is determined that 35.5% (n=43) of patients is A profile, 12.1% (n=15)of patients is B profile, 24.2% (n=30) of patients is C profile, 39.5% (n=47) of patients is A/posterior-lateral alveolar-pleural syndrome (PLAPS), 16.9% (n=21) of patients is A/B profile and 63.7% (n=79) is PLAPS. By using the test of Pearson’s chi-squared for the statistical analyses of lung ultrasonography (p<0.05), diagnoses and profiles were compared. Significant relationship was found between the B profile and congestive heart failure (p=0.002), between the A profile and chronic obstructive pulmonary disease (COPD) acute exacerbation (p=0.003), between being PLAPS (+) and COPD acute exacerbation (p=0.003), between A profile and pneumonia (p=0.017), between C profile and pneumonia (p=0.014). Comparing ultrasonographic evaluations with the discharge from emergency department, hospitalization and 3 month-mortality, it was found that 13.8% of A profile patients (p=0.007), 93.1% of PLAPS (+) patients (p=0.001) died within 3 months, 98% of non-B profile patients (p=0.001) were discharged from emergency department. In conclusion, lung ultrasonography should be used as a diagnostic tool for evaluation of patients suffering from dyspnea.