Back to Search
Start Over
Simplified prediction rule for prognosis of patients with severe community-acquired pneumonia in ICUs.
- Source :
-
Chest [Chest] 1999 Jul; Vol. 116 (1), pp. 157-65. - Publication Year :
- 1999
-
Abstract
- Study Objectives: To develop a simplified prognostic prediction rule for patients admitted to ICUs for severe community-acquired pneumonia (CAP).<br />Setting: Six ICUs in the north of France.<br />Patients: Five hundred five patients admitted to ICUs over a 9-year period (from 1987 to 1995) for severe CAP.<br />Interventions: Retrospective prognosis analysis and multivariate analysis using a credit scoring technique.<br />Measurements: The primary outcome measure was ICU mortality.<br />Results: Among the 505 patients, 472 were eligible for the prognosis study. The ICU mortality rate was 22.9%. Multivariate analysis identified, on the basis of the patient's medical history and initial examination on ICU admission, six independent predictors of mortality: age > or = 40 years, anticipated death within 5 years, nonaspiration pneumonia, chest radiograph involvement > 1 lobe, acute respiratory failure requiring mechanical ventilation, and septic shock. An initial risk score based on these factors classified patients into three risk classes of increasing mortality: 4% in class I, 25% in class II, and 60% in class III. Multivariate analysis of events occurring during ICU stay identified three independent predictors of mortality: hospital-acquired lower respiratory tract superinfections, nonspecific CAP-related complications, and sepsis-related complications. An adjustment risk score based on these factors was essential to accurately predict the final outcome of patients in the initial risk class II.<br />Conclusions: As an aid to clinicians in stratifying the prognosis of patients with severe CAP, the simplified prediction rule used in this study could be useful for therapeutic decisions and appropriate care.
Details
- Language :
- English
- ISSN :
- 0012-3692
- Volume :
- 116
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Chest
- Publication Type :
- Academic Journal
- Accession number :
- 10424520
- Full Text :
- https://doi.org/10.1378/chest.116.1.157