الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 88 |  |  |
| | | from | 88 | | |
Abstract
Heart failure is considered a major healthcare problem that has a huge effect on the morbidity and mortality globally. It is considered one of the leading causes of death worldwide. Any delay or failure in the diagnosis or management of acute heart failure causes significant increase in mortality. Traditionally, the diagnosis of heart failure is based on clinical examination, laboratory data, and imaging techniques. Chest X-ray (CXR) is the easiest approach in patients with suspected acute heart failure, in search for congestion. However, studies clarified that it has low sensitivity for the diagnosis of AHF in comparison to lung ultrasound (LUS). Lung ultrasonography (LUS), being a fast bedside technique, it has attracted many interests to preform studies to assess its ability to detect pleuropulmonary pathologies generally and acute heart failure specifically. The aim of this study was to assess the diagnostic accuracy of the brest score in the diagnosis of AHF in patients presented to the emergency department with acute dyspnea when compared to echocardiography as a gold standard method for diagnosis of heart failure. This was a prospective observational study where 100 patients completed the study, with mean age of 51.10 ± 14.36years and more males (56%). After calculating the brest score for all enrolled patients, a comprehensive echocardiography was done for all patients by a cardiologist to confirm the diagnosis. Accordingly, they were divided into 2 groups. Eighty seven patients (87%) were diagnosed with acute heart failure “HF group”. Thirteen patients (13%) were not diagnosed with heart failure “none HF group”. After plotting ROC curve for the data obtained from the brest score in the diagnosis of AHF in comparison to echocardiography as a gold standard, the brest score was considered a valuable tool to detect the diagnosis of AHF in the intermediate and high probability groups. (AUC=0.930, p ˂0.001, AUC=0.94, p<0.001) respectively. It had extremely adequate results when combined with lung ultrasonography (AUC=0.98, p<0.001, AUC =0.97, p<0.001) in the intermediate and high probability groups respectively. from the results of this study, brest score combined with emergency ultrasonography showed adequate sensitivity and high specificity; and that it might be valuable complement to the standard diagnosis of AHF in emergency settings. Our recommendations are, further larger multicentric studies to study both the application of the brest score in the diagnosis of AHF in patients presented with acute dyspnea in ED and the ability to identify the different lung pathologies in cases of overlapping diagnoses. It is also recommended to apply multiple training programmes to increase the use of clinical scoring like the brest score, which did not wait for laboratory results like other scores, for early diagnosis of AHF in the emergency department for patients presenting with acute dyspnea among emergency physicians. We also recommend the use of lung ultrasonography which had a valuable role for diagnosing or excluding AHF in patients presenting with acute dyspnea in ED.