{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T09:04:24Z","timestamp":1776503064989,"version":"3.51.2"},"reference-count":51,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T00:00:00Z","timestamp":1753574400000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,16]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Point-of-care lung ultrasound (LUS) can assist in diagnosing acute respiratory diseases for its high accuracy and immediate availability at the bedside, including older patients with frailty. Delirium represents a frequent complication of hospitalisation in this setting, frequently triggered by acute respiratory diseases. LUS may therefore help identify individuals at risk of delirium, but the association between LUS abnormalities and delirium remains unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This study is a prospective, observational, multicentre study, with the main objective of assessing the correlation between LUS abnormalities and incident delirium during hospitalisation (primary outcome). The secondary objectives are to assess correlations between lung and diaphragm ultrasound parameters and clinical outcomes including duration of delirium, severity of respiratory failure and mortality. 480 patients aged \u226565 years old, urgently hospitalised after an emergency department visit for acute respiratory complaints, will be recruited in eleven acute geriatric wards located in eight teaching hospitals across Italy. LUS examinations will be performed by skilled clinicians prior to treatment whenever feasible, and in any case within 48 hours from admission. They will also undergo comprehensive geriatric assessment, and daily delirium assessment through the 4-AT tool. The association between LUS abnormalities, related parameters (LUS score, Pleural Effusion Score) and outcomes will be assessed by linear and logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics Committee approval of the coordinating centre (Comitato Etico Territoriale Lombardia 3, reference ID 4369_20.03.2024_M) and collaborative centres has been obtained. All participants will provide written informed consent. Study results will be publicly available following peer-reviewed publication in international scientific journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06670118\">NCT06670118<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-097229","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T10:35:15Z","timestamp":1753698915000},"page":"e097229","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring the correlations of lung ultrasound with delirium and other clinical outcomes in older patients with respiratory failure admitted in acute geriatric units (ECO-AGE): protocol for a multicentre, prospective, observational study from the GRETA Group (Gruppo di Ricerca in Ecografia Toracica nell\u2019Anziano) of the Italian Society of Gerontology and Geriatrics (SIGG)"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06670118","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2969-7393","authenticated-orcid":false,"given":"Chukwuma","family":"Okoye","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy"},{"name":"Acute Geriatric Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ticinesi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, Parma, Italy"},{"name":"Department of Medical Sciences, University of Ferrara, Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5284-9588","authenticated-orcid":false,"given":"Alberto","family":"Finazzi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana Antonella","family":"Bruni","sequence":"additional","affiliation":[{"name":"Acute Geriatric Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Guarino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicoletta","family":"Cerundolo","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, Department of Care Continuity and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Nouvenne","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, Parma, Italy"},{"name":"Internal Medicine Unit, Department of Care Continuity and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmine","family":"Siniscalchi","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, Department of Care Continuity and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiziana","family":"Meschi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, Parma, Italy"},{"name":"Internal Medicine Unit, Department 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Italy"},{"name":"Geriatrics Unit, Department of Care Continuity and Multicomplexity, Parma University-Hospital, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Torrini","sequence":"additional","affiliation":[{"name":"Geriatrics and Intensive Care Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Cerasuolo","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Rosaria","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Monzani","sequence":"additional","affiliation":[{"name":"Casa di Cura Venerabile Confraternita di Misericordia Navacchio, Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Antonelli Incalzi","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy"},{"name":"Department of Medicine and Surgery, Research Unit of Geriatrics, Universit\u00e0 Campus Bio-Medico Di Roma, Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ungar","sequence":"additional","affiliation":[{"name":"Geriatrics and Intensive Care Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, Milano, 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