15 | Use of lung ultrasound in patients hospitalized in the emergency department for pneumonia: distant follow-up and prognostic evaluation through LUS score

Background. Pneumonia is an acute inflammatory process associated with a high rate of morbidity and mortality, representing the leading cause of death from infectious disease worldwide. Lung ultrasound is widely used in all care settings due to its practicality, rapid learning curve, diagnostic accuracy, and its ability to predict negative outcomes and remotely monitor the pathological process.

Methods. Twenty-seven patients hospitalized for pneumonia at the University Emergency Medicine Unit of AOUP between June 2024 and January 2025 were prospectively evaluated. During hospitalization, patients underwent chest ultrasound using a 16-zone reporting scheme. A LUS score was assigned based on the degree of lung aeration. Patients underwent a follow‑up outpatient visit at 5 weeks, including physical examination, blood tests, and repeat chest ultrasound.

Results. The evaluated patients had a mean age of 69.7 years. All underwent lung ultrasound as a diagnostic test; 25 (92.6%) also had a chest X-ray, while 12 (44.4%) underwent a chest CT scan. The topographic concordance between ultrasound and other imaging modalities was 88.5%. Results from lung ultrasound performed at two different time points showed complete resolution of consolidation at follow‑up, as well as a statistically significant reduction in LUS score in all patients analyzed (20.7±6.2 vs 6.1±3, p<0.001). Thanks to this approach, no patient required follow-up imaging involving ionizing radiation. The LUS score allowed prediction of negative outcomes (length of stay, need for ventilation).

Conclusions. Lung ultrasound is a useful method in the diagnostic and management process of patients with pneumonia, reducing the use of heavy radiological investigations. The LUS score proved to be a promising tool for documenting the healing process and predicting significant prognostic information. The findings suggest that the LUS score could be adopted as an early indicator to monitor the evolution of pneumonia and to predict long-term outcomes.