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Meta-Analysis
. 2024 Jan 29;24(1):62.
doi: 10.1186/s12890-023-02826-5.

Lung ultrasound score and in-hospital mortality of adults with acute respiratory distress syndrome: a meta-analysis

Dandan Wang  1 , Yun Qi  2
Affiliations
Meta-Analysis

Lung ultrasound score and in-hospital mortality of adults with acute respiratory distress syndrome: a meta-analysis

Dandan Wang et al. BMC Pulm Med. .

Abstract

Background: Lung ultrasound (LUS) score could quantitatively reflect the lung aeration, which has been well applied in critically ill patients. The aim of the systematic review and meta-analysis was to evaluate the association between LUS score at admission and the risk of in-hospital mortality of adults with acute respiratory distress syndrome (ARDS).

Methods: Toachieve the objective of this meta-analysis, we conducted a thorough search of PubMed, Embase, Cochrane Library, and the Web of Science to identify relevant observational studies with longitudinal follow-up. We employed random-effects models to combine the outcomes, considering the potential influence of heterogeneity.

Results: Thirteen cohort studies with 1,022 hospitalized patients with ARDS were included. Among them, 343 patients (33.6%) died during hospitalization. The pooled results suggested that the LUS score at admission was higher in non-survivors as compared to survivors (standardized mean difference = 0.73, 95% confidence interval [CI]: 0.55 to 0.91, p < 0.001; I2 = 25%). Moreover, a high LUS score at admission was associated with a higher risk of in-hospital mortality of patients with ARDS (risk ratio: 1.44, 95% CI: 1.14 to 1.81, p = 0.002; I2 = 46%). Subgroup analyses showed consistent results in studies with LUS score analyzed with 12 or 16 lung regions, and in studies reporting mortality during ICU or within 1-month hospitalization.

Conclusion: Our findings suggest that a high LUS score at admission may be associated with a high risk of in-hospital mortality of patients with ARDS.

Keywords: Acute respiratory distress syndrome; Lung ultrasound score; Meta-analysis; Mortality; Prognosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of database search and study inclusion
Fig. 2
Fig. 2
Forest plots for the meta-analysis of the difference of LUS score at admission between non-survivors and survivors of ARDS patients; (A), overall meta-analysis; and (B), subgroup analysis according to study design
Fig. 3
Fig. 3
Forest plots for the meta-analysis of the difference of LUS score at admission between non-survivors and survivors of ARDS patients; (A), subgroup analysis according to methods for evaluating LUS score; and (B), subgroup analysis according to follow-up durations
Fig. 4
Fig. 4
Forest plots for the meta-analysis of the association between LUS score at admission and in-hospital mortality of patients with ARDS; (A), overall meta-analysis; (B), subgroup analysis according to study design; and (C), subgroup analysis according to methods for evaluating LUS score
Fig. 5
Fig. 5
Forest plots for the meta-analysis of the association between LUS score at admission and in-hospital mortality of patients with ARDS; (A), subgroup analysis according to the cutoff of LUS score; and (B), subgroup analysis according to follow-up durations
Fig. 6
Fig. 6
Funnel plots for the publication biases underlying the meta-analyses; (A), funnel plots for the meta-analysis of the difference of LUS score at admission between non-survivors and survivors of ARDS patients; and (B), funnel plots for the meta-analysis of the association between LUS score at admission and in-hospital mortality of patients with ARDS
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