Association between lung ultrasound findings and clinical severity in acute bronchiolitis

Abstract

Clinical assessment of acute bronchiolitis is subjective, and reliable bedside tools for severity assessment are needed. The aim of this study was to evaluate the role of lung ultrasound (LUS) findings as objective markers of disease severity in infants with acute bronchiolitis, and to assess their correlation with established clinical severity scores. This observational study included 69 infants with acute bronchiolitis. Clinical severity was assessed using the modified Tal score. LUS was performed using a standardized protocol and LUS scores were calculated. Correlations between LUS score and clinical variables were analyzed using Spearman’s correlation. Interobserver variability was assessed using Cohen’s kappa and intraclass correlation coefficient (ICC). LUS findings and scores differed significantly across severity groups (p < 0.001). All patients with severe clinical bronchiolitis had severe LUS scores. LUS score showed a strong correlation with modified Tal score (r = 0.90, p < 0.001) and a moderate correlation with duration of hospitalization (r = 0.50, p < 0.001). A weak but significant correlation was observed with NLR (r = 0.24, p = 0.05). Interobserver agreement was excellent, with Cohen’s kappa ranging from 0.81 to 0.88 and an ICC of 0.92. Lung ultrasound is a reliable and reproducible bedside tool for assessing disease severity in acute bronchiolitis. Its strong correlation with clinical severity and hospitalization duration supports its integration into routine clinical evaluation.