{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T18:39:30Z","timestamp":1766428770194,"version":"build-2065373602"},"reference-count":80,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Science and Technology Council (TW)","award":["NSTC 112-2410-H-002-174-MY2"],"award-info":[{"award-number":["NSTC 112-2410-H-002-174-MY2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The hospital-at-home (HaH) model offers hospital-level care within patients\u2019 homes and has proven effective for managing conditions such as pneumonia. The point-of-care ultrasonography (PoCUS) is a key diagnostic tool in this model, especially when traditional imaging modalities are unavailable. This review explores how PoCUS can be optimized to manage pneumonia in HaH settings, focusing on its diagnostic accuracy in patients with comorbidities, differentiation from mimickers, and role in assessing disease severity. Pulmonary comorbidities, such as heart failure and interstitial lung disease (ILD), can complicate lung ultrasound (LUS) interpretation. In heart failure, combining lung, cardiac, and venous assessments (e.g., IVC collapsibility, VExUS score) improves diagnostic clarity. In ILD, distinguishing chronic changes from acute infections requires attention to B-line patterns and pleural abnormalities. PoCUS must differentiate pneumonia from conditions such as atelectasis, lung contusion, cryptogenic organizing pneumonia, eosinophilic pneumonia, and neoplastic lesions\u2014many of which present with similar sonographic features. Serial LUS scoring provides useful information on pneumonia severity and disease progression. Studies, particularly during the COVID-19 pandemic, show correlations between worsening LUS scores and poor outcomes, including increased ventilator dependency and mortality. Furthermore, LUS scores correlate with inflammatory markers and gas exchange metrics, supporting their prognostic value. In conclusion, PoCUS in HaH care requires clinicians to integrate multi-organ ultrasound findings, clinical context, and serial monitoring to enhance diagnostic accuracy and patient outcomes. Mastery of LUS interpretation in complex scenarios is crucial to delivering personalized, high-quality care in the home setting.<\/jats:p>","DOI":"10.3390\/diagnostics15101200","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T08:20:23Z","timestamp":1746778823000},"page":"1200","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in Hospital-at-Home Model: Part II\u2014Confounders and Mimickers"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4997-1081","authenticated-orcid":false,"given":"Nin-Chieh","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan"},{"name":"Division of Hospital Medicine, Department of Internal Medicine, Taipei City Hospital Zhongxing Branch, Taipei 103212, Taiwan"},{"name":"Taiwan Association of Hospital Medicine, Taipei 100225, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4350-7755","authenticated-orcid":false,"given":"Yu-Feng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan"},{"name":"Taiwan Association of Hospital Medicine, Taipei 100225, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0689-8339","authenticated-orcid":false,"given":"Hung-Bin","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Internal Medicine, Taipei City Hospital Zhongxing Branch, Taipei 103212, Taiwan"},{"name":"Taiwan Association of Hospital Medicine, Taipei 100225, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Hao","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan"},{"name":"College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1001\/jamainternmed.2018.2562","article-title":"Association of a Bundled Hospital-at-Home and 30-Day Postacute Transitional Care Program With Clinical Outcomes and Patient Experiences","volume":"178","author":"Federman","year":"2018","journal-title":"JAMA Intern. 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