# Lung ultrasound B-lines predict adverse clinical outcomes in adults with sepsis in a resource-limited emergency department

## TL;DR

Lung ultrasound B-lines in sepsis patients are linked to worse outcomes like higher mortality and longer hospital stays, suggesting their use for early risk assessment in resource-limited settings.

## Contribution

Demonstrates that B-lines detected via lung ultrasound can predict adverse outcomes in sepsis patients in resource-limited emergency departments.

## Key findings

- Patients with B-lines had significantly higher mortality rates (16.07% vs. 4.68%).
- B-lines were associated with increased mechanical ventilation use (39.28% vs. 7.03%).
- Hospital stays were longer for patients with B-lines (11 vs. 6 days).

## Abstract

Sepsis increases the risk of acute respiratory distress syndrome (ARDS) and other respiratory complications. Point-of-care lung ultrasound (POCUS) detection of B-lines may facilitate early risk stratification where advanced imaging is limited. This study evaluated the association between B-lines on lung ultrasound and clinical outcomes in adult sepsis patients treated in a resource-limited emergency department.

A retrospective observational study was conducted on sepsis patients treated in the emergency department from January to December 2024. Ultrasound documentation and electronic medical records were analyzed to compare overall mortality, hospital length of stay, and mechanical ventilator use between patients with and without B-lines. Primary outcomes were in-hospital mortality, mechanical ventilator use, and hospital length of stay. Descriptive statistics compared outcomes between patients with and without B-lines. Multivariable logistic regression was used to estimate the adjusted association between B-lines and hospital mortality, controlling for clinically relevant confounders.

Among 184 sepsis patients, 56 (30.43%) exhibited B-lines on lung ultrasound. Mortality rates (16.07% vs. 4.68%, p < 0.001), mechanical ventilation use (39.28% vs. 7.03%, p < 0.001), and median hospital stay duration (11 vs. 6 days, p < 0.001) were compared between the B-lines group and the non-B-lines group. In the multivariable logistic regression analysis, the B-lines group exhibited a significantly higher hospital mortality rate (adjusted odds ratio, 4.6; 95% confidence interval, 2.5–5.5) compared to the non-B-lines group.

The presence of B-lines on lung ultrasound in sepsis patients is significantly associated with increased mortality, higher rates of mechanical ventilation, and prolonged hospital stays. These findings support the potential utility of POCUS B-line assessment for early risk stratification in resource-limited emergency settings.