Abstract:
BACKGROUND:Severe pneumonia requiring ICU admission has not been well characterized with respect to long-term outcomes or predictors thereof. We examined the association between premorbid functional status and mortality in patients with severe pneumonia. METHODS:From 2000 to 2002, a population-based cohort of adults with pneumonia who were critically ill was enrolled and prospectively followed. Short-term (30-day) and long-term (1-year) mortality were examined using multivariable Cox regression models. RESULTS:The final cohort included 271 patients, mean age 61 years, 59% men, and 16% from nursing homes. The mean Pneumonia Severity Index was 113 (71% class IV or V), and the mean Acute Physiology and Chronic Health Evaluation II score was 17. Overall, 121 (45%) patients were functionally independent, 115 (42%) had limited mobility, and 35 (13%) were completely dependent. Mortality was 11% at 30 days and 27% at 1 year; by functional status mortality was 6% at 30 days and 17% at 1 year for patients who were independent, 10% and 31% for patients with limited mobility, and 39% and 48% for patients who were dependent. Mortality was greater for patients who were completely dependent when compared with patients who were independent (adjusted hazard ratio [aHR], 5.3; 95% CI, 2.0-14.1; P < .001 at 30 days; and aHR, 3.0; 95% CI, 1.5-6.1; P = .002 at 1 year) or with patients who had limited mobility (aHR, 4.8; 95% CI, 2.0-11.2, P < .001 at 30 days; and aHR, 2.3; 95% CI, 1.3-4,4, P = .007 at 1 year). There were no mortality differences between patients with limited mobility and patients who were independent. CONCLUSIONS:One-quarter of patients with pneumonia who are critically ill are dead within 1 year. Severely limited premorbid functional status was associated with mortality; this should be considered at presentation for prognosis and at discharge for targeted follow-up.
journal_name
Chestjournal_title
Chestauthors
Sligl WI,Eurich DT,Marrie TJ,Majumdar SRdoi
10.1378/chest.10-1054subject
Has Abstractpub_date
2011-01-01 00:00:00pages
88-94issue
1eissn
0012-3692issn
1931-3543pii
S0012-3692(11)60018-4journal_volume
139pub_type
杂志文章相关文献
CHEST文献大全abstract::The successful use of streptokinase therapy in a child with chronic thrombosis of a prosthetic valve (Carbomedics) in the tricuspid position is presented. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.5.1599
更新日期:1992-11-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate an equation that estimates resting energy expenditure from two easily obtained measurements--expired carbon dioxide and minute ventilation, and compare the results of this equation with standard methods of estimating and measuring caloric expenditure in mechanically ventilated patients. DES...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.2.544
更新日期:1994-02-01 00:00:00
abstract::The purpose of our study was to determine the frequency of cardiac ectopy during the performance of flow-volume loops. The performance of an adequate flow-volume loop entails significant shifts in intrathoracic pressure and oxyhemoglobin saturation that could heighten myocardial arrhythmogenicity and lead to increased...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.4.1006
更新日期:1993-04-01 00:00:00
abstract:STUDY OBJECTIVES:The findings from conventional imaging modalities, such as chest CT, are frequently unreliable in patients with lung cancer. This study was designed to compare the relative diagnostic accuracies and utility of the two most widely used functional imaging examinations, F-18-2-fluoro-2-deoxyglucose (FDG) ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.125.2.494
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVES:To compare the systemic bioavailability (assessed by cortisol suppression) of high-dose budesonide when given by four inhaler devices and orally. Also studied are the relative systemic potencies of three inhaled steroids (budesonide, fluticasone propionate, and beclomethasone dipropionate) when given by mete...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.115.5.1278
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:Choices of pharmacologic therapies for pulmonary arterial hypertension (PAH) are ideally guided by high-level evidence. The objective of this guideline is to provide clinicians advice regarding pharmacologic therapy for adult patients with PAH as informed by available evidence. METHODS:This guideline was bas...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.14-0793
更新日期:2014-08-01 00:00:00
abstract:STUDY OBJECTIVE:This prospective study was performed in an attempt to evaluate (1) the rate of magnetic resonance imaging (MRI) demonstrating bone marrow (BM) abnormalities, (2) the correlation of these abnormalities with a pathologic malignant BM involvement, and (3) the possible modification of patients' usual diseas...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.106.4.1030
更新日期:1994-10-01 00:00:00
abstract::Angiotensin-converting enzyme (ACE) was localized in sarcoid lymph nodes by an in vitro autoradiographic technique using a synthetic ACE inhibitor of high affinity, 125I-labelled 351A. The lymph nodes were from seven patients with active sarcoidosis who underwent mediastinoscopy and from six control subjects who had n...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.90.3.315
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:COPD and hypertension both increase the risk of congestive heart failure (CHF). Current clinical trials do not inform the selection of combination antihypertensive therapy among patients with COPD. We performed a comparative effectiveness study to investigate whether choice of dual agent antihypertensive the...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.12-1770
更新日期:2013-05-01 00:00:00
abstract::Pathologic obstruction of the proximal lumen and secondary atrophy of the media of the peripheral small pulmonary arteries were absolute operative contraindications in cases of VSD and/or PDA with severe pulmonary hypertension. Such patients who were operated on died with no decrease in pulmonary arterial pressure. Th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.1.31
更新日期:1989-07-01 00:00:00
abstract::The relative usefulness of a combination of some tumor markers, such as CEA, AFP, ferritin and NSE for the diagnosis of lung cancer was assessed by multiple logistic analysis. Serum concentration of these markers was determined in 68 patients with lung cancer (50 with NSCLC and 18 with SCLC, in 68 patients with benign...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.3.639
更新日期:1990-03-01 00:00:00
abstract::A patient with ventricular inversion with normally related great vessels and double inlet left ventricle is presented. the patient also showed features of Down's syndrome. Association of ventricular inversion with normally related great vessels is rare and leads to a basic functional state like that of complete transp...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.67.1.98
更新日期:1975-01-01 00:00:00
abstract::Pulmonary manifestations of pyoderma gangrenosum are relatively rare. We report the case of a 45-year-old patient with multiple pulmonary nodules with central necrosis as assessed by CT scan. The patient had a 4-year history of pyoderma gangrenosum with only minor skin manifestations. A CT-guided, fine-needle biopsy o...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.119.3.977
更新日期:2001-03-01 00:00:00
abstract:STUDY OBJECTIVES:To examine the utilization of chemoprophylaxis for tuberculosis in certain high-risk groups, ie, infected contacts 50 years and older, and to study the safety of isoniazid (INH) preventive therapy in such persons. DESIGN:From 1987 to 1992, two-part questionnaires were sent to each of the regional heal...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.3.706
更新日期:1995-09-01 00:00:00
abstract::Mycobacterium tuberculosis (MTB) isolation from clinical specimens is the standard for TB diagnosis. Positive MTB cultures are rarely questioned, but false-positive culture rates range from 2% to 4%. In December 2011, two smear-negative, culture-positive TB cases were reported to the Oklahoma State Department of Healt...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.12-2294
更新日期:2013-07-01 00:00:00
abstract::In this pilot study, murine monoclonal anti-TNF antibody (2 mg/kg) was administered to ten patients within 24 h of septic shock which persisted after initial resuscitation with intravenous fluids and adrenergic agents. This treatment resulted in a reduction in heart rate (from 122 +/- 10 to 113 +/- 10 beats per minute...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.101.3.810
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Urine output (UO) is a vital sign for critically ill patients, but standards for monitoring and reporting vary widely between ICUs. Careful monitoring of UO could lead to earlier recognition of acute kidney injury (AKI) and better fluid management. We sought to determine if the intensity of UO monitoring is ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2017.05.011
更新日期:2017-11-01 00:00:00
abstract::The variation in respiratory water loss (RWL) over time, expressed as the mass of water vapor lost per liter (body temperature and pressure, saturated) of ventilation (MH2O), was investigated in two groups: (1) children with exercise-induced asthma; and (2) healthy children. Children were matched for age and sex and w...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.94.1.81
更新日期:1988-07-01 00:00:00
abstract::A CO2 rebreathing method for the measurement of cardiac output was evaluated by comparison with the direct Fick O2 method in 26 studies performed in 18 patients who were critically ill. The method requires measurement of CO2 output by collection of expired gas, of arterial PCO2, and of mixed venous PCO2 by rebreathing...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.73.2.167
更新日期:1978-02-01 00:00:00
abstract:BACKGROUND:The longitudinal associations between depression or anxiety and COPD, and their comorbid effect on prognosis, have not been adequately addressed by previous reviews. We aimed to systematically assess these associations to inform guidelines and practice. METHODS:We searched electronic databases for articles ...
journal_title:Chest
pub_type: 杂志文章,meta分析,评审
doi:10.1378/chest.12-1911
更新日期:2013-09-01 00:00:00
abstract:INTRODUCTION:Pulmonary arterial hypertension (PAH) is the most common cause of scleroderma-related deaths. New medications for PAH patients make it necessary to identify patients with high risk factors for PAH. This study looks at the use of an exercise echocardiogram in identifying patients who may have PAH and may be...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.07-2324
更新日期:2008-07-01 00:00:00
abstract:STUDY OBJECTIVE:The benefit of smoking cessation just prior to surgery in preventing postoperative pulmonary complications has not been proven. Some studies actually show a paradoxical increase in complications in those quitting smoking only a few weeks or days prior to surgery. We studied the effect of smoking and the...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.127.6.1977
更新日期:2005-06-01 00:00:00
abstract::Pneumocystis carinii pneumonia is a frequent manifestation of the acquired immune deficiency syndrome (AIDS). It usually presents radiologically as diffuse bilateral infiltrates and histologically as a foamy, eosinophilic intra-alveolar exudate containing the organisms' cysts. We recently studied two rare cases of P c...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.94.3.580
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:To produce an improved, COPD-specific version of the St. George respiratory questionnaire (SGRQ-C). METHODS:Five different steps were required: (1) Rasch analysis of the responses of 893 COPD patients to the St. George respiratory questionnaire (SGRQ) identified weaker items to be removed; (2) a scoring algo...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.06-0702
更新日期:2007-08-01 00:00:00
abstract::Ten patients who take hydroxy-methylglutaryl coenzyme A reductase inhibitors, or statin medications, and experience adverse reactions are described. All patients experienced various manifestations of hypersensitivity while receiving the drugs. One patient is described with hypersensitivity pneumonitis, which was graph...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.115.3.886
更新日期:1999-03-01 00:00:00
abstract::A 42-year-old woman with an anomalous left coronary artery originating from the pulmonary artery and a fistula from the left coronary artery to the left ventricle was treated by aortocoronary bypass grafting of an autologous saphenous vein. The presence of an abundant collateral circulation and of fistulous communicat...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.74.1.102
更新日期:1978-07-01 00:00:00
abstract::We studied eleven patients during 14 attempts at weaning from mechanical ventilation to determine whether central ventilatory drive, measured as airway occlusion pressure 0.1 s after onset of inspiration (P 0.1), during spontaneous breathing before and during a brief hypercapnic challenge, could accurately predict the...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.91.4.496
更新日期:1987-04-01 00:00:00
abstract::A protocol was originally designed to study breathing control during and following cardiac arrest in humans, taking advantage of the period of pulseless ventricular fibrillation (PVF) produced while testing a newly implanted cardioverter-defibrillator device. A patient aged in his 60s with New York Heart Association c...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.12-2950
更新日期:2013-10-01 00:00:00
abstract::In this study we determine the prevalence and type of arrhythmias that occur during postural drainage and chest percussion (PDP) of critically ill patients, and identify those patients who are most at risk of developing them. We monitored the vital signs and ECGs of 72 ICU patients during their initial PDP treatment. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.6.1836
更新日期:1992-12-01 00:00:00
abstract::The factors that influence decision making among surgeons are not well understood. We evaluated how tumor stage in patients subjected to potentially curative surgery for lung cancer affects the self-reported follow-up strategies employed by practicing surgeons. Hypothetical patient profiles and a detailed questionnair...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.111.1.99
更新日期:1997-01-01 00:00:00