Evaluation of the IDSA/ATS Minor Criteria for Severe Community-Acquired Pneumonia
| Autor: | Grant P. Redrow, Antonio Anzueto, Esmeralda Lugo, Marcos I. Restrepo, Elena Laserna, Eric M. Mortensen, Oriol Sibila |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Minor (academic) Artificial respiration Severity of Illness Index Hypoxemia Community-acquired pneumonia Predictive Value of Tests medicine Humans Vasoconstrictor Agents In patient Hospital Mortality Hospitals Teaching Intensive care medicine Societies Medical Retrospective Studies Mechanical ventilation business.industry Pneumonia General Medicine medicine.disease Respiration Artificial Texas Community-Acquired Infections Practice Guidelines as Topic Emergency medicine Cohort Female medicine.symptom business |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 2377-1003 2154-8331 |
| Popis: | Our aim was to evaluate the minor criteria recommended by the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) as predictors of 30-day mortality, the need for invasive mechanical ventilation, and/or the need for vasopressor support as markers of severity in patients hospitalized with community-acquired pneumonia (CAP).Patients admitted to 2 academic teaching hospitals over a 4-year period (January 1, 1999 to December 1, 2002) were identified as having CAP. We used modified minor criteria established by the 2007 IDSA/ATS guidelines. The primary outcome measure was 30-day mortality, and the secondary outcome measures were need for invasive mechanical ventilation and/or need for vasopressor support.About half of the patients in the cohort (n = 352/787 [46%]) had ≥ 1 minor criterion, but only 128 (16.3%) had ≥ 3 minor criteria present at hospital admission. In the multivariable analysis, hypoxemia, multilobar infiltrates, and leukopenia were associated with 30-day mortality (P0.05). In addition, hypoxemia and confusion/disorientation were associated with the need for invasive mechanical ventilation and/or vasopressor support (P0.05). The presence of ≥ 3 minor criteria was associated with 30-day mortality (odds ratio, 4.82), and the need for invasive mechanical ventilation and/or vasopressor support (odds ratio, 2.59).Our results show that hypoxemia, multilobar infiltrates, and leukopenia were the most predictive minor criteria for 30-day mortality. In contrast, hypoxemia and confusion/disorientation were the 2 individual minor severe criteria that were more likely to require invasive mechanical ventilation and/or vasopressor support. At least 3 2007 IDSA/ATS minor severe criteria were associated with 30-day mortality and need for invasive mechanical ventilation and/or vasopressor support. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|