Killip scale reclassification according to lung ultrasound: Killip pLUS

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  • dc.contributor.author Carreras-Mora, José
  • dc.contributor.author Vidal Burdeus, María
  • dc.contributor.author Rodríguez González, Clara
  • dc.contributor.author Simón-Ramón, Clara
  • dc.contributor.author Rodríguez Sotelo, Laura
  • dc.contributor.author Sionis, Alessandro
  • dc.contributor.author Giralt Borrell, Teresa
  • dc.contributor.author Martínez Membrive, María José
  • dc.contributor.author Izquierdo-Marquisá, Andrea
  • dc.contributor.author Cainzos-Achirica, Miguel
  • dc.contributor.author Vaquerizo Montilla, Beatriz
  • dc.contributor.author Rivas-Lasarte, Mercedes
  • dc.contributor.author Ribas Barquet, Núria
  • dc.date.accessioned 2025-01-28T17:37:43Z
  • dc.date.embargoEnd info:eu-repo/date/embargoEnd/2025-07-24
  • dc.date.issued 2024
  • dc.description.abstract Aims: The Killip scale remains a fundamental tool for prognostic assessment in ST-segment elevation myocardial infarction (STEMI) due to its simplicity and predictive value. Lung ultrasound (LUS) has emerged as a valuable adjunct for diagnosing and predicting outcomes in heart failure (HF) and STEMI patients, even those with subclinical congestion. We created a new classification (Killip pLUS), which reclassifies Killip I and II patients into an intermediate category (Killip I pLUS) based on LUS results. This category included Killip I patients and ≥1 positive zone (≥3 B-lines) and Killip II with 0 positive zones. We aimed to evaluate this new classification by comparing it with the Killip scale and a previous LUS-based reclassification scale (LUCK scale). Methods and results: Lung ultrasound was performed within 24 h of admission in a multicentre cohort of 373 patients admitted for STEMI. In-hospital mortality and major adverse cardiovascular events within one year after admission, comprising mortality or readmission for HF, acute coronary syndrome, or stroke, were analysed. When predicting in-hospital mortality, the global comparison of these three classifications was statistically significant: Killip pLUS area under the curve (AUC) 0.90 (95% CI 0.85-0.95) vs. Killip AUC 0.85 (95% CI 0.73-0.96) vs. LUCK 0.83 (95% CI 0.70-0.95), P = 0.024. To predict events during follow-up, the comparison between scales was also significant: Killip pLUS 0.77 (95% CI 0.71-0.85) vs. Killip 0.72 (95% CI 0.65-0.79) vs. LUCK 0.73 (95% CI 0.66-0.81), P = 0.033. Conclusion: The Killip pLUS scale provides enhanced risk stratification compared to the Killip and LUCK scales while preserving simplicity.
  • dc.embargo.liftdate 2025-07-24
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Carreras-Mora J, Vidal-Burdeus M, Rodríguez-González C, Simón-Ramón C, Rodríguez-Sotelo L, Sionis A, et al. Killip scale reclassification according to lung ultrasound: Killip pLUS. Eur Heart J Acute Cardiovasc Care. 2024 Jul 24;13(7):566-9. DOI: 10.1093/ehjacc/zuae073
  • dc.identifier.doi http://dx.doi.org/10.1093/ehjacc/zuae073
  • dc.identifier.issn 2048-8726
  • dc.identifier.uri http://hdl.handle.net/10230/69352
  • dc.language.iso eng
  • dc.publisher Oxford University Press
  • dc.relation.ispartof Eur Heart J Acute Cardiovasc Care. 2024 Jul 24;13(7):566-9
  • dc.rights © Oxford University Press. This is a pre-copyedited, author-produced version of an article accepted for publication in European heart journal. Acute cardiovascular care following peer review. The version of record Carreras-Mora J, Vidal-Burdeus M, Rodríguez-González C, Simón-Ramón C, Rodríguez-Sotelo L, Sionis A, et al. Killip scale reclassification according to lung ultrasound: Killip pLUS. Eur Heart J Acute Cardiovasc Care. 2024 Jul 24;13(7):566-9. DOI: 10.1093/ehjacc/zuae073 is available online at: http://dx.doi.org/10.1093/ehjacc/zuae073.
  • dc.rights.accessRights info:eu-repo/semantics/embargoedAccess
  • dc.subject.keyword B-lines
  • dc.subject.keyword Killip scale
  • dc.subject.keyword Lung ultrasound
  • dc.subject.keyword STEMI
  • dc.title Killip scale reclassification according to lung ultrasound: Killip pLUS
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/acceptedVersion

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