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

Background: 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. Methods: 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. Results: Among 184 sepsis patients, 56 (30.43%) exhibited B-lines on lung ultrasound. Mortality rates (16.07% vs. 4.68%, Conclusion: 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.