Reliability of crackles in fibrotic interstitial lung disease: a prospective, longitudinal study

被引:0
作者
Sgalla, Giacomo [1 ,2 ]
Simonetti, Jacopo [1 ]
Di Bartolomeo, Arianna [1 ]
Magri, Tonia [1 ]
Iovene, Bruno [2 ]
Pasciuto, Giuliana [2 ]
Dell'Ariccia, Ruben [1 ]
Varone, Francesco [2 ]
Comes, Alessia [1 ]
Leone, Paolo Maria [2 ]
Piluso, Venere [1 ]
Perrotta, Alessandro [1 ]
Cicchetti, Giuseppe [3 ]
Verdirosi, Diana [2 ]
Richeldi, Luca [1 ,2 ]
机构
[1] Univ Cattolica Sacro Cuore, Rome, Italy
[2] Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Neurosci Organi Senso & Torace, Unita Operativa Complessa Pneumol, Largo Agostino Gemelli 8, Rome 100168, Italy
[3] Fdn Policlin Univ A Gemelli IRCCS, Ctr Avanzato Radiodiagnost, Dipartimento Diagnost Immagini & Radioterapia Onco, Rome, Italy
关键词
Crackles; Interstitial lung disease; Lung sounds; Pulmonary fibrosis; IDIOPATHIC PULMONARY-FIBROSIS; EARLY-DIAGNOSIS; HEART-FAILURE; DOUBLE-BLIND; STANDARDIZATION; PIRFENIDONE; STATEMENT; UPDATE;
D O I
10.1186/s12931-024-02979-9
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
BackgroundAlthough crackles on chest auscultation represent a fundamental component of the diagnostic suspect for fibrotic interstitial lung disease (ILD), their reliability has not been properly studied. We assessed the agreement among respiratory physicians on the presence and changes over time of audible crackles collected in a prospective longitudinal cohort of patients with fibrotic ILD.MethodsLung sounds were digitally recorded at baseline and after 12 months at eight anatomical sites. Nine respiratory physicians blindly assessed randomized couples of recordings obtained from the same anatomical site at different timepoints. The physicians indicated the presence of crackles in individual recordings and which recording from each couple eventually had more intense crackles. Fleiss' kappa coefficient was used to measure inter- and intra-rater agreement.ResultsFifty-two patients, mostly with a diagnosis of IPF (n = 40, 76.9%) were prospectively enrolled between October 2019 and May 2021. The final acoustic dataset included 702 single recordings, corresponding to 351 couples of recordings from baseline and 12-months timepoints. Kappa coefficient was 0.57 (95% CI 0.55-0.58) for the presence of crackles and 0.42 (95% CI 0.41-0.43) for acoustic change. Intra-rater agreement, measured for three respiratory physicians on three repeated assessments, ranged from good to excellent for the presence of crackles (kappa = 0.87, kappa = 0.86, kappa = 0.79), and from moderate to good for acoustic change (kappa = 0.75, kappa = 0.76, kappa = 0.57).ConclusionsAgreement between respiratory physicians for the presence of crackles and acoustic change was acceptable, suggesting that crackles represent a reliable acoustic finding in patients with fibrotic ILD. Their role as a lung-derived indicator of disease progression merits further studies.
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页数:11
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