Evaluation of the IDSA/ATS minor criteria for severe community-acquired pneumonia.

Oriol Sibila, Eric M. Mortensen, Grant Redrow, Esmeralda Lugo, Elena Laserna, Antonio Anzueto, Marcos I. Restrepo

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Our aim was to evaluate the minor criteria recommended by the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) as predictors of 30-day mortality, the need for invasive mechanical ventilation, and/or the need for vasopressor support as markers of severity in patients hospitalized with community-acquired pneumonia (CAP). Patients admitted to 2 academic teaching hospitals over a 4-year period (January 1, 1999 to December 1, 2002) were identified as having CAP. We used modified minor criteria established by the 2007 IDSA/ATS guidelines. The primary outcome measure was 30-day mortality, and the secondary outcome measures were need for invasive mechanical ventilation and/or need for vasopressor support. About half of the patients in the cohort (n = 352/787 [46%]) had ≥ 1 minor criterion, but only 128 (16.3%) had ≥ 3 minor criteria present at hospital admission. In the multivariable analysis, hypoxemia, multilobar infiltrates, and leukopenia were associated with 30-day mortality (P < 0.05). In addition, hypoxemia and confusion/disorientation were associated with the need for invasive mechanical ventilation and/or vasopressor support (P < 0.05). The presence of ≥ 3 minor criteria was associated with 30-day mortality (odds ratio, 4.82), and the need for invasive mechanical ventilation and/or vasopressor support (odds ratio, 2.59). Our results show that hypoxemia, multilobar infiltrates, and leukopenia were the most predictive minor criteria for 30-day mortality. In contrast, hypoxemia and confusion/disorientation were the 2 individual minor severe criteria that were more likely to require invasive mechanical ventilation and/or vasopressor support. At least 3 2007 IDSA/ATS minor severe criteria were associated with 30-day mortality and need for invasive mechanical ventilation and/or vasopressor support.

Original languageEnglish (US)
Pages (from-to)158-164
Number of pages7
JournalHospital practice (1995)
Volume40
Issue number2
StatePublished - Apr 2012

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Artificial Respiration
Communicable Diseases
Pneumonia
Thorax
Mortality
Leukopenia
Odds Ratio
Outcome Assessment (Health Care)
Teaching Hospitals
Guidelines
Hypoxia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Sibila, O., Mortensen, E. M., Redrow, G., Lugo, E., Laserna, E., Anzueto, A., & Restrepo, M. I. (2012). Evaluation of the IDSA/ATS minor criteria for severe community-acquired pneumonia. Hospital practice (1995), 40(2), 158-164.

Evaluation of the IDSA/ATS minor criteria for severe community-acquired pneumonia. / Sibila, Oriol; Mortensen, Eric M.; Redrow, Grant; Lugo, Esmeralda; Laserna, Elena; Anzueto, Antonio; Restrepo, Marcos I.

In: Hospital practice (1995), Vol. 40, No. 2, 04.2012, p. 158-164.

Research output: Contribution to journalArticle

Sibila, O, Mortensen, EM, Redrow, G, Lugo, E, Laserna, E, Anzueto, A & Restrepo, MI 2012, 'Evaluation of the IDSA/ATS minor criteria for severe community-acquired pneumonia.', Hospital practice (1995), vol. 40, no. 2, pp. 158-164.
Sibila O, Mortensen EM, Redrow G, Lugo E, Laserna E, Anzueto A et al. Evaluation of the IDSA/ATS minor criteria for severe community-acquired pneumonia. Hospital practice (1995). 2012 Apr;40(2):158-164.
Sibila, Oriol ; Mortensen, Eric M. ; Redrow, Grant ; Lugo, Esmeralda ; Laserna, Elena ; Anzueto, Antonio ; Restrepo, Marcos I. / Evaluation of the IDSA/ATS minor criteria for severe community-acquired pneumonia. In: Hospital practice (1995). 2012 ; Vol. 40, No. 2. pp. 158-164.
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