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defining and predicting severe community acquired pneumonia

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https://www.readbyqxmd.com/read/27683509/the-national-early-warning-score-news-for-outcome-prediction-in-emergency-department-patients-with-community-acquired-pneumonia-results-from-a-6-year-prospective-cohort-study
#1
Diana Sbiti-Rohr, Alexander Kutz, Mirjam Christ-Crain, Robert Thomann, Werner Zimmerli, Claus Hoess, Christoph Henzen, Beat Mueller, Philipp Schuetz
OBJECTIVE: To investigate the accuracy of the National Early Warning Score (NEWS) to predict mortality and adverse clinical outcomes for patients with community-acquired pneumonia (CAP) compared to standard risk scores such as the pneumonia severity index (PSI) and CURB-65. DESIGN: Secondary analysis of patients included in a previous randomised-controlled trial with a median follow-up of 6.1 years. SETTINGS: Patients with CAP included on admission to the emergency departments (ED) of 6 tertiary care hospitals in Switzerland...
September 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/27398948/serial-procalcitonin-levels-for-predicting-prognosis-in-community-acquired-pneumonia
#2
Akihiro Ito, Tadashi Ishida, Hiromasa Tachibana, Yuhei Ito, Takuya Takaiwa
BACKGROUND AND OBJECTIVE: This study aimed to investigate the usefulness of addition of serial measurements of procalcitonin (PCT) to C-reactive protein (CRP) values and pneumonia severity scores, such as CURB-65 (confusion, urea > 7 mmol/L, respiratory rate ≥ 30 breaths/min, low blood pressure (systolic < 90 mm Hg or diastolic ≤ 60 mm Hg) and age ≥ 65 years) and the Pneumonia Severity Index, and attempted to create and evaluate a new scoring system for predicting mortality risk using the biomarkers and pneumonia severity scores...
November 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27240938/determination-of-neutrophil-cd64-expression-as-a-prognostic-biomarker-in-patients-with-community-acquired-pneumonia
#3
J Burgos, I Los-Arcos, D Álvarez de la Sierra, V Falcó, A Aguiló, I Sánchez, B Almirante, M Martinez-Gallo
The expression of CD64 in neutrophils (nCD64) has shown utility in the diagnosis of sepsis. The aim of this study was to assess the usefulness of nCD64 expression to identify patients with community-acquired pneumonia (CAP) at risk of a poor outcome. A prospective study of nCD64 expression (determined by flow cytometry) in patients with CAP was performed. The sensitivity/specificity of nCD64 in predicting poor outcome [defined as intensive care unit (ICU) admission and/or clinical deterioration after arrival at the emergency department] was calculated...
September 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27230573/prognostic-value-of-mid-regional-pro-adrenomedullin-mr-proadm-in-patients-with-community-acquired-pneumonia-a-systematic-review-and-meta-analysis
#4
Dan Liu, Lixin Xie, Haiyan Zhao, Xueyao Liu, Jie Cao
BACKGROUND: The early identification of patients at risk of dying from community-acquired pneumonia (CAP) is critical for their treatment and for defining hospital resource consumption. Mid-regional pro-adrenomedullin (MR-proADM) has been extensively investigated for its prognostic value in CAP. However, the results are conflicting. The purpose of the present meta-analysis was to explore the diagnostic accuracy of MR-proADM for predicting mortality in patients suffering from CAP, particularly emergency department (ED) patients...
2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27174880/predictive-and-prognostic-factors-in-patients-with-blood-culture-positive-community-acquired-pneumococcal-pneumonia
#5
Rosanel Amaro, Adamantia Liapikou, Catia Cilloniz, Albert Gabarrus, Francesc Marco, Jacobo Sellares, Eva Polverino, Javier Garau, Miquel Ferrer, Daniel M Musher, Antoni Torres
In patients with pneumococcal community-acquired pneumonia (CAP), the risk factors for bacteraemia and its impact on outcomes are not fully elucidated. We aimed to compare characteristics of patients with blood-culture-positive versus blood-culture-negative pneumococcal CAP, and to characterise bacteraemic serotypes.We describe a prospective, observational study on nonimmunocompromised patients with pneumococcal CAP, from 1996 to 2013. We define severe pneumonia according to American Thoracic Society/Infectious Diseases Society of America guidelines...
September 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/26648706/the-effect-trial-evaluating-exacerbations-biomarkers-and-safety-outcomes-with-two-dose-levels-of-fluticasone-propionate-formoterol-in-copd
#6
Alberto Papi, Paul W Jones, Prashant S Dalvi, Kirsten McAulay, Tammy McIver, Sanjeeva Dissanayake
Inhaled corticosteroid/long-acting β2-agonist combination therapy is recommended in chronic obstructive pulmonary disease (COPD) patients at high risk of exacerbations. The EFFECT (Efficacy of Fluticasone propionate/FormotErol in COPD Treatment) trial is a Phase III, 52-week, randomized, double-blind study to evaluate the efficacy and safety of two doses of fluticasone propionate/formoterol compared to formoterol monotherapy in COPD patients with FEV1 ≥50% predicted and a history of exacerbations. The primary endpoint is the annualized rate of moderate and severe exacerbations...
2015: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/26528363/can-procalcitonin-add-to-the-prognostic-power-of-the-severity-scoring-system-in-adults-with-pneumonia
#7
HamidReza Naderi, Fereshte Sheybani, MohammadReza Sarvghad, Mehdi Jabbari Nooghabi
BACKGROUND: The first decision confronting clinicians in the management of patients with community acquired pneumonia (CAP) is whether the patient is to be hospitalized or not. We sought to validate the pneumonia scoring system and assess the power of procalcitonin (PCT) level to predict in-hospital mortality (IHM) and intensive vasopressor and respiratory support (IVRS) requirements in patients with CAP. MATERIALS AND METHODS: A total of 120 patients with CAP were evaluated for severity of illness based on the defined scoring systems including pneumonia severity index (PSI), confusion, urea, respiratory rate, blood pressure, age>65 (CURB-65), confusion, respiratory rate, blood pressure, age>65 (CRB-65), infectious diseases society of America/American thoracic society 2007 criteria (IDSA/ATS 2007) and systolic blood pressure, multilobar infiltrate, albumin, respiratory rate, tachycardia, confusion, low oxygen, low pH (SMART-COP)...
2015: Tanaffos
https://www.readbyqxmd.com/read/26113245/prognostic-value-of-serum-pregnancy-associated-plasma-protein-a-level-at-the-initial-ed-presentation-in-elderly-patients-with-cap
#8
Yalcin Golcuk, Burcu Golcuk, Adnan Bilge, Ayhan Korkmaz, Mehmet Irik, Mustafa Hayran, Alper Tunga Ozdemir, Yusuf Kurtulmus
OBJECTIVE: This study aims to compare serum pregnancy-associated plasma protein A (PAPP-A) levels in surviving and nonsurviving elderly patients with community-acquired pneumonia (CAP), investigating whether PAPP-A is correlated with CAP prediction scores and whether PAPP-A can successfully predict 28-day mortality rates in elderly patients. METHODS: This prospective, observational, single-center, cross-sectional study was conducted at the emergency department (ED) of Celal Bayar University Hospital in Manisa, Turkey, between January and September 2014...
September 2015: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26030588/usefulness-of-midregional-proadrenomedullin-to-predict-poor-outcome-in-patients-with-community-acquired-pneumonia
#9
Susana Gordo-Remartínez, María Calderón-Moreno, Juan Fernández-Herranz, Ana Castuera-Gil, Mar Gallego-Alonso-Colmenares, Carolina Puertas-López, José A Nuevo-González, Domingo Sánchez-Sendín, Mercedes García-Gámiz, José A Sevillano-Fernández, Luis A Álvarez-Sala, Juan A Andueza-Lillo, José M de Miguel-Yanes
BACKGROUND: midregional proadrenomedullin (MR-proADM) is a prognostic biomarker in patients with community-acquired pneumonia (CAP). We sought to confirm whether MR-proADM added to Pneumonia Severity Index (PSI) improves the potential prognostic value of PSI alone, and tested to what extent this combination could be useful in predicting poor outcome of patients with CAP in an Emergency Department (ED). METHODS: Consecutive patients diagnosed with CAP were enrolled in this prospective, single-centre, observational study...
2015: PloS One
https://www.readbyqxmd.com/read/25782758/community-acquired-pneumonia-as-medical-emergency-predictors-of-early-deterioration
#10
Martin Kolditz, Santiago Ewig, Benjamin Klapdor, Hartwig Schütte, Johannes Winning, Jan Rupp, Norbert Suttorp, Tobias Welte, Gernot Rohde
BACKGROUND: Early organ dysfunction determines the prognosis of community-acquired pneumonia (CAP), and recognition of CAP as a medical emergency has been advocated. OBJECTIVE: To characterise patients with 'emergency CAP' and evaluate predictors for very early organ failure or death. METHODS: 3427 prospectively enrolled patients of the CAPNETZ cohort were included. Emergency CAP was defined as requirement for mechanical ventilation or vasopressor support (MV/VS) or death within 72 h and 7 days after hospital admission, respectively...
June 2015: Thorax
https://www.readbyqxmd.com/read/25687620/combination-of-mean-platelet-volume-and-the-curb-65-score-better-predicts-28-day-mortality-in-patients-with-community-acquired-pneumonia
#11
Yalcin Golcuk, Burcu Golcuk, Adnan Bilge, Mehmet Irik, Onur Dikmen
OBJECTIVE: This study aims to investigate whether mean platelet volume (MPV) is correlated with the CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, >65 years of age) score, and whether a combination of the CURB-65 score with MPV could better predict the 28-day mortality in patients with community-acquired pneumonia (CAP). METHODS: This prospective, observational, single-center, and cross-sectional study was conducted at emergency department (ED) between September 1, 2013, and July 31, 2014...
May 2015: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25618316/short-term-mortality-of-adult-inpatients-with-community-acquired-pneumonia-external-validation-of-a-modified-curb-65-score
#12
COMPARATIVE STUDY
Marc Andre Pflug, Timothy Tiutan, Thomas Wesemann, Harald Nüllmann, Hans Jürgen Heppner, Ludger Pientka, Ulrich Thiem
OBJECTIVE: The management of community-acquired pneumonia (CAP) continues to be a challenge, especially in older people. To enable better risk stratification, a variation of the severity scores CRB-65 and CURB-65, called CURB-age, has been suggested. We compared the association between risk groups as defined by the scores and 30-day mortality for a cohort of mainly older inpatients with CAP. METHODS: We retrospectively analysed data from the CAP database from the years 2005 to 2009 of a single centre in Herne, Germany...
February 2015: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/25495677/the-incidence-of-cardiovascular-events-after-hospitalization-due-to-cap-and-their-association-with-different-inflammatory-markers
#13
Olga Rajas, Mara Ortega-Gómez, José María Galván Román, José Curbelo, Guillermo Fernández Jiménez, Lorena Vega Piris, Francisco Rodríguez Salvanes, Belén Arnalich, Sergio Luquero Bueno, Ana Díaz López, Hortensia de la Fuente, Carmen Suárez, Julio Ancochea, Javier Aspa
BACKGROUND: Late prognosis of Community-Acquired Pneumonia (CAP) patients is related to cardiovascular events. Persistence of inflammation-related markers, defined by high circulatory levels of interleukin 6 and 10 (IL-6/IL-10), is associated with a higher post-event mortality rate for CAP patients. However, association between these markers and other components of the immune response, and the risk of cardiovascular events, has not been adequately explored. The main objectives of this study are: 1) to quantify the incidence of cardiovascular disease, in the year post-dating their hospital admittance due to CAP and, 2) to describe the distribution patterns of a wide spectrum of inflammatory markers upon admittance to and release from hospital, and to determine their relationship with the incidence of cardiovascular disease...
2014: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/25043135/early-non-invasive-ventilation-treatment-for-respiratory-failure-due-to-severe-community-acquired-pneumonia
#14
Antonello Nicolini, Gianluca Ferraioli, Maura Ferrari-Bravo, Cornelius Barlascini, Mario Santo, Lorenzo Ferrera
BACKGROUND AND AIMS: Severe community-acquired pneumonia (sCAP) have been as defined pneumonia requiring admission to the intensive care unit or carrying a high risk of death. Currently, the treatment of sCAP consists of antibiotic therapy and ventilator support. The use of invasive ventilation causes several complications as does admission to ICU. For this reason, non-invasive ventilation (NIV) has been used for acute respiratory failure to avoid endotracheal intubation. However, few studies have currently assessed the usefulness of NIV in sCAP...
January 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/24972956/a-high-resolution-computed-tomography-based-scoring-system-to-differentiate-the-most-infectious-active-pulmonary-tuberculosis-from-community-acquired-pneumonia-in-elderly-and-non-elderly-patients
#15
MULTICENTER STUDY
Jun-Jun Yeh, Solomon Chih-Cheng Chen, Cheng-Ren Chen, Ting-Chun Yeh, Hsin-Kai Lin, Jia-Bin Hong, Bing-Tsang Wu, Ming-Ting Wu
OBJECTIVE: The objective of this study was to use high-resolution computed tomography (HRCT) imaging to predict the presence of smear-positive active pulmonary tuberculosis (PTB) in elderly (at least 65 years of age) and non-elderly patients (18-65 years of age). METHODS: Patients with active pulmonary infections seen from November 2010 through December 2011 received HRCT chest imaging, sputum smears for acid-fast bacilli and sputum cultures for Mycobacterium tuberculosis...
October 2014: European Radiology
https://www.readbyqxmd.com/read/24597687/is-elevated-red-cell-distribution-width-a-prognostic-predictor-in-adult-patients-with-community-acquired-pneumonia
#16
Eyal Braun, Jad Kheir, Tanya Mashiach, Mohammad Naffaa, Zaher S Azzam
BACKGROUND: Community acquired pneumonia (CAP) is a major cause of morbidity and mortality. We recently demonstrated that among young patients (<60 years old) with CAP, elevated red blood cell distribution width (RDW) level on admission was associated with significant higher rates of mortality and severe morbidity. We aimed to investigate the prognostic predictive value of RDW among CAP patients in general population of internal wards. METHODS: The cohort included patients of 18 years old or older who were diagnosed with CAP (defined as pneumonia identified 48 hours or less from hospitalization) between January 1, 2005 and December 31, 2010...
2014: BMC Infectious Diseases
https://www.readbyqxmd.com/read/24589380/predictors-and-impact-of-time-to-clinical-stability-in-community-acquired-pneumococcal-pneumonia
#17
Kazuto Takada, Shuuichi Matsumoto, Eiji Kojima, Susumu Iwata, Kiyoko Ninomiya, Kentarou Tanaka, Daiki Goto, Takahiro Shimizu, Kango Nohara
BACKGROUND: A clinical stability (CS) evaluation is thought to be important in community-acquired pneumonia (CAP) treatment, but evidence concerning the time to CS (TCS) remains lacking. METHODS: Among consecutive patients hospitalized with pneumococcal pneumonia, relationships between TCS and other clinical outcomes were examined, and predictors and a predictive TCS score were derived from patient characteristics on admission. RESULTS: A total of 144 patients were enrolled, including 46% and 27% with moderate and severe pneumonia, respectively, defined by the pneumonia severity index (PSI)...
May 2014: Respiratory Medicine
https://www.readbyqxmd.com/read/24447823/external-validation-of-the-cursi-criteria-confusion-urea-respiratory-rate-and-shock-index-in-adults-hospitalised-for-community-acquired-pneumonia
#18
COMPARATIVE STUDY
Harald Nüllmann, Marc Andre Pflug, Thomas Wesemann, Hans-Jürgen Heppner, Ludger Pientka, Ulrich Thiem
BACKGROUND: For patients hospitalised due to community-acquired pneumonia (CAP), mortality risk is usually estimated with prognostic scores such as CRB-65 or CURB-65. For elderly patients, a new score referred to as CURSI has been proposed which uses shock index (SI) instead of the blood pressure (B) and age (65) criteria. The new score has not been externally validated to date. METHODS: We used data from a hospital-based CAP registry to compare the ability of CURSI, CURB-65 and CRB-65 to predict mortality at day 30 after hospital admission...
2014: BMC Infectious Diseases
https://www.readbyqxmd.com/read/24388023/risk-stratification-for-cardiac-complications-in-patients-hospitalized-for-community-acquired-pneumonia
#19
Vicente F Corrales-Medina, Monica Taljaard, Michael J Fine, Girish Dwivedi, Jeffrey J Perry, Daniel M Musher, Julio A Chirinos
OBJECTIVE: To derive and validate a clinical rule that stratifies the risk of cardiac complications in patients hospitalized for community-acquired pneumonia (CAP) and compare its performance to the pneumonia severity index (PSI) score. PATIENTS AND METHODS: Two cohorts of patients hospitalized for CAP were selected for the study. We used regression techniques in the derivation cohort (1343 patients enrolled in the Pneumonia Patient Outcomes Research Team study between October 1991 and March 1994) to generate a prediction rule that we validated in the validation cohort (608 patients enrolled in the Dissemination of Guidelines for Length of Stay study between February 1998 and March 1999)...
January 2014: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/24053273/prediction-of-prognosis-by-markers-in-community-acquired-pneumonia
#20
REVIEW
Diego Viasus, Antonella Simonetti, Carolina Garcia-Vidal, Jordi Carratalà
Early identification of patients with community-acquired pneumonia (CAP) at risk of poor outcome is critical for defining site of care and may impact on hospital resource consumption and prognosis. The Pneumonia Severity Index and CURB-65 are clinical rules that accurately identify individuals at risk of death. However, these scores have some limitations. Therefore in recent years, increasing attention has been being paid to research on biomarkers, since they have the potential to resolve fundamental issues regarding prognostic prediction that cannot be readily addressed using CAP-specific scores...
September 2013: Expert Review of Anti-infective Therapy
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