Abstract:
:The aim of the present study was to investigate whether the pneumonia severity index (PSI) could adequately predict the severity of community-acquired pneumonia (CAP) and could be used as a severity of illness classification system. Furthermore, reasons that may influence the decision to admit low risk patients were analysed. In a prospective study 260 patients with CAP were included. Stratification in five risk classes according to the PSI was compared with parameters that are closely related to severity of CAR A significant difference in severity parameters, such as length of stay (P < 0.001) and simplified acute physiologic score and acute physiologic and chronic health evaluation II score (P < 0.001) was found between the five risk classes. Furthermore, a positive British Thoracic Society (BTS) rule and modified BTS rule score was significantly more prevalent in the higher risk classes (P < 0.001). The patient population had an average 30-day mortality of 10% and a mean Intensive Care Unit (ICU) admission rate of 8%. The mortality rate and ICU admission rate significantly differed between the five risk classes (P < 0.001), in which the highest ICU admission rate (40.9%) and the highest mortality percentage (40.9%) were both found in risk class V. Several clinical factors (n = 64), such as an exacerbation of chronic obstructive pulmonary disease in 17 patients and clinical appearance of being ill in 16 patients, lack of improvement on outpatient antibiotic therapy (n = 15) and social circumstances (n = 3) were reasons that influenced the decision to hospitalise low risk patients (n = 82). The results show that the PSI adequately predicted the severity of CAP and can be used as a severity of illness classification in CAP. Clinical and social factors other than those mentioned in the PSI have to be considered when making the decision to hospitalise patients with CAP.
journal_name
Respir Medjournal_title
Respiratory medicineauthors
van der Eerden MM,de Graaff CS,Bronsveld W,Jansen HM,Boersma WGdoi
10.1016/j.rmed.2004.02.022subject
Has Abstractpub_date
2004-09-01 00:00:00pages
872-8issue
9eissn
0954-6111issn
1532-3064pii
S0954-6111(04)00101-5journal_volume
98pub_type
杂志文章abstract:STUDY OBJECTIVES:Penicillin resistance has been reported in various studies to have no impact on the outcome of pneumococcal pneumonia. However, the importance of cephalosporin resistance has not been systematically studied. We conducted an analysis of patients with high-level cephalosporin-resistant Streptococcus pneu...
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
doi:10.1016/j.rmed.2008.07.015
更新日期:2009-01-01 00:00:00
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doi:10.1016/s0954-6111(03)00119-7
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更新日期:2017-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:1995-10-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1993-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.rmed.2007.02.024
更新日期:2007-08-01 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:2014-09-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1053/rmed.1999.0678
更新日期:2000-01-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2017-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2018-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0954-6111(98)90228-1
更新日期:1998-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.rmed.2006.02.011
更新日期:2006-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.rmed.2007.12.010
更新日期:2008-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.rmed.2016.05.012
更新日期:2016-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.rmed.2017.02.020
更新日期:2017-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.rmed.2005.09.034
更新日期:2006-06-01 00:00:00
abstract::Increased levels of exhaled nitric oxide (FeNO) and airway hyperresponsiveness (AHR) to inhaled mannitol are related to allergic inflammation characterized by eosinophil infiltration and a clinical response to treatment with anti-inflammatory agents in subjects with asthma. This study determines the diagnostic accurac...
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pub_type: 杂志文章
doi:10.1016/j.rmed.2012.09.004
更新日期:2013-01-01 00:00:00