Artículos de revistas
Severe community-acquired pneumonia: Assessment of severity criteria
Fecha
1998Registro en:
American Journal of Respiratory and Critical Care Medicine, Volumen 158, Issue 4, 2018, Pages 1102-1108
1073449X
10.1164/ajrccm.158.4.9803114
Autor
Ewig, Santiago
Ruiz, Mauricio
Mensa, Josep
Marcos, Maria Angeles
Martinez, Jose Antonio
Arancibia, Francisco
Niederman, Michael S.
Torres, Antoni
Institución
Resumen
The purpose of the study was to validate the criteria used in the guidelines of the American Thoracic Society (ATS) for severe community- acquired pneumonia (CAP). Severe pneumonia was defined as admission to the intensive care unit (ICU). Overall 331 nonsevere (84%) and 64 severe cases (16%) of CAP were prospectively studied. Mortality was 19 of 395 (5%) and 19 of 64 (30%), respectively. Single severity criteria as well as the ATS definition of severe pneumonia were assessed calculating the operative indices. A modified prediction rule including minor (baseline) and major (baseline or evolutionary) criteria was derived. Single minor criteria at admission had a low sensitivity and positive predictive value. Defining severe pneumonia according to the ATS guidelines had a high sensitivity (98%). However, specificity and positive predictive value were low (32% and 24%, respectively). A modified prediction rule (presence of two or three minor criteria [systolic blood pressure < 90 mm Hg, m