Abstract:
BACKGROUND:A paucity of studies have assessed the epidemiology of community-acquired pneumonia (CAP) that require ICU admission. We conducted a study on this group of patients with the primary objective of defining the incidence, epidemiology, and mortality rate of CAP in the ICUs in Louisville, Kentucky. The secondary objective was to estimate the number of patients who were hospitalized and the number of deaths that were associated with CAP in ICU in the United States. RESEARCH QUESTIONS:What is epidemiology of CAP in the ICU in Louisville, Kentucky, and the projected incidence in the United States? STUDY DESIGN AND METHODS:This was a secondary analysis of a prospective population-based cohort study. The setting was all nine adult hospitals in Louisville, Kentucky. The annual incidence of CAP in the ICU per 100,000 adults was calculated for the whole adult population of Louisville. The number of patients who were hospitalized because of CAP in ICU in the United States was estimated by multiplying the Louisville incidence rate of CAP in ICU by the 2014 US adult population. RESULTS:From a total of 7,449 unique patients who were hospitalized with CAP, 1,707 patients (23%) were admitted to the ICU. The incidence of CAP in the ICU was 145 cases per 100,000 population of adults. Cases of CAP in the ICU were clustered in patients from areas of the city with high poverty. The mortality rate of patients with CAP in ICU was 27% at 30 days and 47% at one year. In the United States, the estimated number of patients who were hospitalized with CAP requiring the ICU was 356,326 per year, and the estimated number of deaths at 30 days and one year were 96,206 and 167,474, respectively. INTERPRETATION:Almost one in five patients who are hospitalized with CAP requires intensive care. Poverty is associated with CAP in the ICU. Nearly one-half of patients with CAP in the ICU will die within one year. Because of its significant burden, CAP in the ICU should be a high priority in research agenda and health policy.
journal_name
Chestjournal_title
Chestauthors
Cavallazzi R,Furmanek S,Arnold FW,Beavin LA,Wunderink RG,Niederman MS,Ramirez JAdoi
10.1016/j.chest.2020.03.051subject
Has Abstractpub_date
2020-09-01 00:00:00pages
1008-1016issue
3eissn
0012-3692issn
1931-3543pii
S0012-3692(20)30676-0journal_volume
158pub_type
杂志文章相关文献
CHEST文献大全abstract::The mechanisms leading to rapid changes in arterial blood gas values soon after exercise ends have not been well established. To further study these phenomena, we exercised seven normal male volunteers to exhaustion on a cycle ergometer with a 25-W/min ramped protocol measuring arterial blood gas values, and breath-by...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.99.5.1145
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Sarcoidosis is thought to be a T-helper type 1 cytokine-mediated disorder. Sputum induction has been proposed as a useful noninvasive method mainly for the assessment of airway diseases. However, it is unknown whether the balance of T-cytotoxic (Tc1) type 1 and Tc2 cells is altered in sarcoidosis. STUDY OBJ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.129.6.1592
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:Devices that reduce technical difficulty and anastigmatic time when repairing large vessels such as the thoracic aorta would be beneficial. The aim of this study was to determine if titanium vascular closure staples (3 mm) could be safely and quickly applied in the repair of large vessels such as the thoracic...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.118.6.1762
更新日期:2000-12-01 00:00:00
abstract::To evaluate the morbidity associated with obstructve sleep apnea syndrome (OSAS), we undertook a seven-year follow-up study of 198 OSAS patients seen between 1972 and 1980. The patients had been submitted to tracheostomy (71 patients) or had received a weight-loss recommendation (127 patients). Despite a lower mean ap...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.1.27
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Little is known about factors determining the pathogenesis and severity of asthma in Latin American countries. Costa Rica, one of the most prosperous Latin American nations, has a very high asthma prevalence. OBJECTIVE:To examine the relation between potential risk factors and childhood asthma in Costa Rica...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.120.3.785
更新日期:2001-09-01 00:00:00
abstract::A prospective study was done to compare four different methods of securing oral endotracheal tubes: adhesive tape (A), Twill tape (T), Twill tape with FlexBlue bite block (TFXB), and Velcro tie with FlexBlue (VFXB), used on sequential days. Thirty-six patients were enrolled for 136 patient-days and 18 had complete 4-d...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.104.5.1537
更新日期:1993-11-01 00:00:00
abstract:STUDY OBJECTIVES:The differential diagnosis of syndrome X and coronary artery disease (CAD) in patients with evidence of myocardial ischemia may be difficult. The possible difference in coronary calcium detected by electron-beam CT (EBCT) between syndrome X and CAD is rarely evaluated, especially in aged patients with ...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.120.5.1525
更新日期:2001-11-01 00:00:00
abstract::Previous reports have suggested that infusions of lidocaine (lignocaine) cause a high incidence of phlebitis. We investigated the possibility of reducing this high incidence by the addition of small amounts of heparin or hydrocortisone (or both) to the infusate of lidocaine. One hundred patients with acute myocardial ...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.84.4.439
更新日期:1983-10-01 00:00:00
abstract::Coronary artery fistulas have been traditionally diagnosed by angiography. This report describes a congenital and a traumatic coronary artery fistula diagnosed by transesophageal echocardiography. Transesophageal echocardiography was superior to transthoracic echocardiography in both cases and to angiography in one ca...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.3.959
更新日期:1994-03-01 00:00:00
abstract::This study describes an unusual patient with X-linked Alport syndrome (XLAS) in whom diffuse alveolar hemorrhage (DAH) developed as a complication of alemtuzumab therapy following renal transplantation. A 26-year-old man with XLAS underwent retransplantation with a cadaveric renal allograft. He received alemtuzumab th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.07-2354
更新日期:2008-06-01 00:00:00
abstract:STUDY OBJECTIVES:To determine whether the likelihood of lung nodule calcification can be predicted from nodule size as measured on a chest radiograph (CXR). DESIGN:Retrospective review of CXRs of patients with lung nodules < or =1 cm in size detected on CT scanning. CT images were used to identify calcifications and t...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.118.3.610
更新日期:2000-09-01 00:00:00
abstract::A total of 161 patients with chronic obstructive pulmonary disease (COPD) plus 100 control subjects (identified during a study of heart disease in 6,860 Japanese-American men aged 52 to 75 years who were residing in Hawaii) were analyzed for phenotype in search of the antitrypsin gene Z, which has been shown to be ass...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.72.4.489
更新日期:1977-10-01 00:00:00
abstract::alpha 1-Antitrypsin (alpha 1-AT) accumulates in the rough endoplasmic reticulum through a mechanism of polymerization. Polymerization is favored by the incorrect tertiary structure of the alpha 1-AT caused by a point mutation at position 342 of the protein. Accumulation of alpha 1-AT in the liver cells (and in hepatoc...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.110.6_supplement.251s
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Architectural design of health-care facilities can influence patient safety; however, it is unknown whether patient outcomes are significantly affected by ICU design. METHODS:Six hundred sixty-four patients admitted to the medical ICU (MICU) of Columbia University Medical Center during 2008 were included in...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.09-1458
更新日期:2010-05-01 00:00:00
abstract::Severe head injury often results in hypoxemia, but the pathophysiology of this phenomenon is unclear. We studied 24 patients hospitalized after severe head injury to determine whether the abnormality of oxygen transfer as measured by venous admixture (Qs/Qt) was associated with a reduction in functional residual capac...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.84.1.29
更新日期:1983-07-01 00:00:00
abstract:STUDY OBJECTIVES:The purpose of this study was to investigate the test-retest reliability, repeatability, and sensitivity of the modified shuttle test (MST) in adult patients with cystic fibrosis (CF). DESIGN:: Prospective study. SETTING:Adult CF Unit, Belfast City Hospital. PATIENTS:: Adult patients with CF. INTER...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.117.6.1666
更新日期:2000-06-01 00:00:00
abstract::Congenital diaphragmatic hernia (CDH) is associated with a variety of cardiac anomalies. However, its association with hypoplastic left heart syndrome (HLHS) is rare. We treated a female newborn with CDH, HLHS, and omphalocele. The operation for omphalocele and the diaphragmatic defect was successful, although the pat...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.1.263
更新日期:1992-01-01 00:00:00
abstract::Hospitalizations for patients with acute exacerbations of COPD are associated with several adverse patient outcomes as well as with significant health-care costs. Despite many interventions targeted at reducing readmissions following an initial hospitalization, there are few strategies that have been consistently asso...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1016/j.chest.2019.06.005
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Traditional diagnostic tests for pericardial tuberculosis (TB) are insensitive and often require long culture periods, and this has led to more emphasis being placed on biochemical tests such as the pericardial adenosine deaminase (ADA) test. However, controversy exists as to its diagnostic utility. In addit...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.3.900
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:It would be valuable to have a noninvasive method of measuring impaired pulmonary gas exchange in patients with lung disease and thus reduce the need for repeated arterial punctures. This study reports the results of using a new test in a group of outpatients attending a pulmonary clinic. METHODS:Inspired a...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2018.02.001
更新日期:2018-08-01 00:00:00
abstract::We carried out a medical and environmental survey to evaluate respiratory disease at two tungsten carbide (TC) production plants. The study population of 290 subjects (19.2 percent of the total work force) was chosen to focus on those with the greatest potential exposures to cobalt, a binding agent which is probably t...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.86.4.549
更新日期:1984-10-01 00:00:00
abstract::The role of thoracic radiation therapy in the management of limited-stage small cell lung cancer (SCLC) is reviewed. Although chest irradiation has been used to treat SCLC for over four decades, its standard role in the management of limited-stage disease was established only during the last decade. Multiple prospecti...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.112.4_supplement.259s
更新日期:1997-10-01 00:00:00
abstract:STUDY OBJECTIVES:To investigate the roles of human alpha-defensin (HAD), human beta-defensin (HBD)-1, and HBD-2, novel antimicrobial peptides, in patients with Mycobacterium avium-intracellulare infection (MAI). PATIENTS:The study included 25 patients (10 men) with MAI who visited our hospital between June 1998 and Au...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.119.4.1131
更新日期:2001-04-01 00:00:00
abstract::We report an individual with limb-girdle muscular dystrophy who has devised a way to assist her respiration by using her hands braced against the tray of her wheelchair. Utilizing this method, she was able to increase her tidal volume (VT) and lower her respiratory rate compared to unassisted spontaneous breathing, th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.123.3.949
更新日期:2003-03-01 00:00:00
abstract::Hyperinflation with intrinsic positive end-expiratory pressure (PEEPi) loads the respiratory muscles and causes dyspnea in obstructive lung disease. Continuous positive airway pressure (CPAP) has shown some efficacy in reducing inspiratory work and dyspnea. However, in obstructive lung disease, inspiratory work and dy...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.2.432
更新日期:1995-08-01 00:00:00
abstract:STUDY OBJECTIVES:Preoperative renal dysfunction is a risk factor for adverse events in cardiac surgery. This study compared creatinine clearance (ClCr), estimated from the Cockroft and Gault formula, and plasma creatinine level as predictors of outcome after cardiac surgery. DESIGN:Prospective, observational. SETTING...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.124.5.1852
更新日期:2003-11-01 00:00:00
abstract::In a double-blind, crossover study, nebulized ketanserin, a 5-HT2 receptor antagonist, and a placebo were given to eight patients with moderate to severe nonasthmatic COPD. Intravenous ketanserin had rapid onset of action and induced a longer lasting bronchial response than inhaled ketanserin. These results confirm th...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.97.4.901
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:The improved lung deposition of hydrofluoroalkane-134a beclomethasone dipropionate (HFA-BDP) extrafine aerosol compared with chlorofluorocarbon beclomethasone dipropionate (CFC-BDP) suggests that lower doses of HFA-BDP may be required to provide equivalent asthma control. The present study was undertaken to t...
journal_title:Chest
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.115.2.343
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:Skeletal muscle dysfunction occurring as a result of ICU admission associates with higher mortality. Although preadmission higher BMI correlates with better outcomes, the impact of baseline muscle and fat mass has not been defined. We therefore investigated the association of skeletal muscle and fat mass at ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2018.10.023
更新日期:2019-02-01 00:00:00
abstract::A case of double-orifice mitral valve in a 16-year-old Japanese boy is presented. Two-dimensional echocardiography, including transesophageal approach, showed two approximately equal orifices with three papillary muscles. Color Doppler echocardiography showed a mild mitral regurgitation from both orifices. No other ca...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.104.5.1616
更新日期:1993-11-01 00:00:00