A new scoring system for early diagnosis of ventilator-associated pneumonia: LUPPIS
| Autor: | Ismail Cinel, Lutfiye Mulazimoglu Durmusoglu, Murat Haliloglu, Huseyin Bilginer, Beliz Bilgili, Umut Sabri Kasapoğlu, Melek Süzer Aslan, İsmet Sayan |
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| Přispěvatelé: | Haliloglu, Murat, Bilgili, Beliz, Bilginer, Huseyin, Kasapoglu, Umut Sabri, Sayan, Ismet, Aslan, Melek Suzer, Durmusoglu, Lutfiye Mulazimoglu, Cinel, Ismail |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Scoring system medicine.medical_treatment BIOMARKERS ATTRIBUTABLE MORTALITY GUIDELINES Procalcitonin law.invention 03 medical and health sciences ventilator-associated pneumonia 0302 clinical medicine CHEST RADIOGRAPHY law Clinical Research Internal medicine LONG PENTRAXIN PTX3 Medicine 030212 general & internal medicine Prospective cohort study lung ultrasound Mechanical ventilation ULTRASOUND ASSESSMENT business.industry RECOGNITION Ventilator-associated pneumonia General Medicine medicine.disease bacterial infections and mycoses C-REACTIVE PROTEIN respiratory tract diseases Pneumonia Gram staining INFECTIONS Clinical Pulmonary Infection Score pentraxin-3 SOFA score business |
| Zdroj: | Archives of Medical Science : AMS |
| ISSN: | 1734-1922 |
| Popis: | Introduction: The Clinical Pulmonary Infection Score (CPIS) based on chest X-ray has been developed to facilitate clinical diagnosis of ventilator-associated pneumonia (VAP); however, this scoring system has a low diagnostic performance. We developed the Lung Ultrasound and Pentraxin-3 Pulmonary Infection Score (LUPPIS) for early diagnosis of VAP and evaluated the performance of this new scoring system. Material and methods: In a prospective study of 78 patients with suspected VAP, we assessed the detection accuracy of LUPPIS for pneumonia in adult patients. We also evaluated the diagnostic performance of pentraxin-3 (PTX-3) findings of infection. On the day of the study, lung ultrasound was performed, PTX-3 levels were determined, and an endotracheal aspirate was obtained for Gram staining and culture. Results: No significant differences were found between groups with respect to age, mechanical ventilation time, APACHE II score, or SOFA score (p > 0.05). Procalcitonin and PTX-3 levels were significantly higher in the VAP (+) group (p < 0.001 and p < 0.001, respectively). The threshold for LUPPIS in differentiating VAP (+) patients from VAP (-) patients was > 7. In predicting VAP, LUPPIS > 7 (sensitivity of 84%, specificity of 87.7%) was superior to CPIS > 6 (sensitivity of 40.1%, specificity of 84.5%). Conclusions: LUPPIS appears to provide better results in the prediction of VAP compared to CPIS, and the importance of lung ultrasound and PTX-3 is emphasized, which is a distinctive property of LUPPIS. |
| Databáze: | OpenAIRE |
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