Investigation of the effect of B-line count changes on predicting mortality in patients presenting to the emergency department with acute heart failure exacerbation: A prospective cohort study

Tavrak, E. Investigation of the Effect of B-Line Count Changes on Predicting Mortality in Patients Presenting to the Emergency Department with Acute Heart Failure Exacerbation: A Prospective Cohort Study. Eskişehir Osmangazi University Faculty of Medicine, Department of Emergency Medicine Medical Specialization Thesis, Eskişehir, 2025. The process of diagnosing heart failure in the emergency department and predicting mortality and morbidity in these patients presents significant challenges due to the heterogeneity of clinical findings, comorbid conditions, and the need for rapid decision-making. This study aimed to investigate the role of B-line counts measured by focused lung ultrasound (LUS) in predicting mortality and treatment response in heart failure patients presenting to the emergency department with dyspnea. After obtaining approval from the Ethics Committee, the study was conducted as a single-center, prospective study. A total of 156 patients aged 18 years and older diagnosed with heart failure according to the NYHA classification were included in the study. A high B-line count at the time of admission and a persistently high B-line count after treatment were found to be associated with poor prognosis and higher mortality rates. When the B-line change ratio was ≤%21.05, it was found to be a significant predictor of one-month mortality, and when the change ratio was ≤%19.05, it was a significant predictor of three-month mortality in terms of sensitivity and specificity. This study demonstrated that B-line counts and their change ratios, obtained via lung ultrasonography, could serve as effective markers for predicting mortality in heart failure patients. Specifically, a post-treatment B-line count above 21 and a B-line change ratio below certain threshold values appear to be clinically useful parameters in assessing the mortality risk of patients. Key Words: Heart Failure, Lung Ultrasonography, B-Lines, Cutoff Value