Mortality among severe community-acquired pneumonia patients depends on combinations of 2007 IDSA/ATS minor criteria
Objectives: The individual 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) minor criteria for severe community-acquired pneumonia (CAP) are of unequal weight in predicting mortality. It is not clear whether the combinations of predictive findings might imply diverse...
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doaj-b07366632ea04a159b0751699ca87e432020-11-25T01:09:42ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112015-09-0138C14114510.1016/j.ijid.2015.07.026Mortality among severe community-acquired pneumonia patients depends on combinations of 2007 IDSA/ATS minor criteriaHai-yan Li0Qi Guo1Wei-dong Song2Yi-ping Zhou3Ming Li4Xiao-ke Chen5Hui Liu6Hong-lin Peng7Hai-qiong Yu8Xia Chen9Nian Liu10Zhong-dong Lü11Li-hua Liang12Qing-zhou Zhao13Mei Jiang14Department of Primary Care, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Respiratory Medicine, Affiliated Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China, 518036Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Respiratory Medicine, Affiliated Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China, 518036Department of Radiology, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Department of Radiology, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China, 518033Guangzhou Institute of Respiratory Diseases (State Key Laboratory of Respiratory Diseases), First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China, 510120Objectives: The individual 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) minor criteria for severe community-acquired pneumonia (CAP) are of unequal weight in predicting mortality. It is not clear whether the combinations of predictive findings might imply diverse severities or different mortalities. Methods: A prospective two centre cohort study was performed of 385 severe CAP patients fulfilling three or more IDSA/ATS minor criteria amongst 1430 patients. Results: Hospital mortality rose sharply from 5.7%, 9.9%, and 16.5%, respectively, for patients with none of three predictive findings most strongly associated to mortality (PaO2/FiO2 ≤ 250 mm Hg, confusion and uraemia), one of those, and two of those to 38.6% for patients with all those (p < 0.001). The number of three predictive findings present had a significantly increased odds ratio for mortality of 2.796 (p < 0.001), and had the degree of positive association with sequential organ failure assessment scores at 72 hours, incurring significantly longer hospital stay and higher costs. Conclusions: Different combinations of 2007 IDSA/ATS minor criteria for severe CAP were associated to diverse severities and different mortalities. The combination of PaO2/FiO2 ≤ 250 mm Hg, confusion and uraemia predicted more severity and higher mortality compared with others.http://www.sciencedirect.com/science/article/pii/S1201971215001940Severe community-acquired pneumoniaMinor criteriaCombinationMortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hai-yan Li Qi Guo Wei-dong Song Yi-ping Zhou Ming Li Xiao-ke Chen Hui Liu Hong-lin Peng Hai-qiong Yu Xia Chen Nian Liu Zhong-dong Lü Li-hua Liang Qing-zhou Zhao Mei Jiang |
spellingShingle |
Hai-yan Li Qi Guo Wei-dong Song Yi-ping Zhou Ming Li Xiao-ke Chen Hui Liu Hong-lin Peng Hai-qiong Yu Xia Chen Nian Liu Zhong-dong Lü Li-hua Liang Qing-zhou Zhao Mei Jiang Mortality among severe community-acquired pneumonia patients depends on combinations of 2007 IDSA/ATS minor criteria International Journal of Infectious Diseases Severe community-acquired pneumonia Minor criteria Combination Mortality |
author_facet |
Hai-yan Li Qi Guo Wei-dong Song Yi-ping Zhou Ming Li Xiao-ke Chen Hui Liu Hong-lin Peng Hai-qiong Yu Xia Chen Nian Liu Zhong-dong Lü Li-hua Liang Qing-zhou Zhao Mei Jiang |
author_sort |
Hai-yan Li |
title |
Mortality among severe community-acquired pneumonia patients depends on combinations of 2007 IDSA/ATS minor criteria |
title_short |
Mortality among severe community-acquired pneumonia patients depends on combinations of 2007 IDSA/ATS minor criteria |
title_full |
Mortality among severe community-acquired pneumonia patients depends on combinations of 2007 IDSA/ATS minor criteria |
title_fullStr |
Mortality among severe community-acquired pneumonia patients depends on combinations of 2007 IDSA/ATS minor criteria |
title_full_unstemmed |
Mortality among severe community-acquired pneumonia patients depends on combinations of 2007 IDSA/ATS minor criteria |
title_sort |
mortality among severe community-acquired pneumonia patients depends on combinations of 2007 idsa/ats minor criteria |
publisher |
Elsevier |
series |
International Journal of Infectious Diseases |
issn |
1201-9712 1878-3511 |
publishDate |
2015-09-01 |
description |
Objectives: The individual 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) minor criteria for severe community-acquired pneumonia (CAP) are of unequal weight in predicting mortality. It is not clear whether the combinations of predictive findings might imply diverse severities or different mortalities.
Methods: A prospective two centre cohort study was performed of 385 severe CAP patients fulfilling three or more IDSA/ATS minor criteria amongst 1430 patients.
Results: Hospital mortality rose sharply from 5.7%, 9.9%, and 16.5%, respectively, for patients with none of three predictive findings most strongly associated to mortality (PaO2/FiO2 ≤ 250 mm Hg, confusion and uraemia), one of those, and two of those to 38.6% for patients with all those (p < 0.001). The number of three predictive findings present had a significantly increased odds ratio for mortality of 2.796 (p < 0.001), and had the degree of positive association with sequential organ failure assessment scores at 72 hours, incurring significantly longer hospital stay and higher costs.
Conclusions: Different combinations of 2007 IDSA/ATS minor criteria for severe CAP were associated to diverse severities and different mortalities. The combination of PaO2/FiO2 ≤ 250 mm Hg, confusion and uraemia predicted more severity and higher mortality compared with others. |
topic |
Severe community-acquired pneumonia Minor criteria Combination Mortality |
url |
http://www.sciencedirect.com/science/article/pii/S1201971215001940 |
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