Abstract:
STUDY OBJECTIVES:The aim was to evaluate demographic, clinical, and laboratory variables in febrile patients, with or without a microbiologically confirmed infection, for prediction of death, in comparison to the systemic inflammatory response syndrome (SIRS) and its criteria, such as abnormal temperature, tachycardia, tachypnea, and abnormal WBC count, and to sepsis, that includes SIRS and an infection. DESIGN:A prospective cohort study. SETTING:Department of internal medicine at a university hospital. PATIENTS:In 300 consecutive, hospitalized medical patients with new onset of fever, demographic, clinical, and laboratory variables were obtained during the 2 days after inclusion, while microbiological results for a follow-up period of 7 days were collected. Patients were followed up for survival or death, up to a maximum of 28 days after inclusion. MEASUREMENTS AND RESULTS:Of all patients, 95% had SIRS, 44% had sepsis with a microbiologically confirmed infection, and 9% died. A model with a set of variables all significantly (p<0.01) contributing to the prediction of mortality was derived. The set included the presence of hospital-acquired fever, the peak respiratory rate, the nadir score on the Glasgow coma scale, and the nadir albumin plasma level within the first 2 days after inclusion. This set of variables predicted mortality for febrile patients with microbiologically confirmed infection even better. The predictive values for mortality of SIRS and sepsis were less than that of our set of variables. CONCLUSIONS:In comparison to SIRS and sepsis, the new set of variables predicted mortality better for all patients with fever and also for those with microbiologically confirmed infection only. This type of effort may help in refining definitions of SIRS and sepsis, based on prognostically important demographic, clinical, and laboratory variables that are easily obtainable at the bedside.
journal_name
Chestjournal_title
Chestauthors
Bossink AW,Groeneveld J,Hack CE,Thijs LGdoi
10.1378/chest.113.6.1533subject
Has Abstractpub_date
1998-06-01 00:00:00pages
1533-41issue
6eissn
0012-3692issn
1931-3543pii
S0012-3692(16)31495-7journal_volume
113pub_type
杂志文章相关文献
CHEST文献大全abstract:BACKGROUND:alpha(1)-Antitrypsin (AAT)-Z deficiency is a risk factor for the development of COPD. Compared to wild-type M, AAT-Z has an increased tendency to polymerize, rendering it inactive as a serine proteinase inhibitor. It has been demonstrated that wild-type M- and Z-deficiency AAT polymers are chemotactic for hu...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.129.6.1683
更新日期:2006-06-01 00:00:00
abstract::Malignant mesothelioma is an uncommon and usually fatal cancer, for which there is no standard treatment. However, surgical resection remains the mainstay of treatment because of the inability to treat the entire hemithorax effectively with radiation and the lack of effective chemotherapy drugs. Extrapleural pneumonec...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.4_supplement.382s
更新日期:1993-04-01 00:00:00
abstract::Fungal endocarditis is a rare complication of permanent pacemaker implantation. In all reports we have identified, this infection has been fatal, diagnosed postmortem. We present a patient in whom early echocardiographic diagnosis resulted in curative surgical and antimicrobial therapy. Fungal endocarditis is an unusu...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.1.283
更新日期:1993-01-01 00:00:00
abstract::In order to identify correlates of fibrosis in acute respiratory failure, autopsies were performed on 16 patients who died after an episode of more than two weeks' duration, and the left lower lung lobe was obtained for biochemical measurements. The average amount of lobar collagen in one group of patients was nearly ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.85.5.641
更新日期:1984-05-01 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 72-year-old man presented with malaise, weight loss, and cough. Chest radiograph revealed bilateral pleural effusions. On thoracentesis, the left effusion was a clear yellow exudate with more than 90% lymphocytes, and the right effusion was a grossly bloody exudate with more than 90% neutrophils. Cultures of both ef...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.110.3.849
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:To compare the utilization and outcomes of critical care services in a cohort of hospitals in the United States and Japan. DESIGN:Prospective data collection on 5,107 patients and detailed organizational characteristics from each of the participating Japanese study hospitals between 1993 and 1995, with compa...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.121.2.539
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:No studies have attempted to examine the genetic influence on the habit of snoring. The aim of the present study was to examine whether an association existed between self-reported snoring and family history of snoring and a number of genetic markers. MATERIAL AND METHODS:The data were derived from a primar...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.107.5.1289
更新日期:1995-05-01 00:00:00
abstract::This study investigated the effect of dynamic exercise on mitral regurgitation (MR) as assessed by color flow Doppler imaging and tested the hypothesis that MR increases in patients with left ventricular (LV) function worsening during exercise. We studied 513 patients (390 men, 123 women:mean age [+/-1 SD] 58+/-11 yea...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.114.4.1075
更新日期:1998-10-01 00:00:00
abstract::Vasospasm of RP is thought to occur in the lungs. To assess pulmonary vasospasm, we analyzed the early and late Dsb variations after a digital CPT. Sixteen normal volunteers and 20 patients (7 with primary, 13 with secondary RP) were included. A clinical RP was conducted on ten patients, nine with secondary and one wi...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.5.1312
更新日期:1992-05-01 00:00:00
abstract::Patients presenting with partial atrioventricular septal (PAVC) defects in adulthood are rare. Eight adult patients with this congenital heart defect who had surgical repair are described, along with their long-term postoperative follow-up data. Average age at operation was 48 years, and average follow-up was 13.4 yea...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.94.2.321
更新日期:1988-08-01 00:00:00
abstract::We conducted a study of ultrasound (US)-guided pleural biopsy with a Tru-Cut needle and made a comparison with the results of a traditional pleural biopsy with an Abrams needle. A total of 49 patients with unilateral pleural effusion were included in this study. Twenty-four patients underwent a traditional pleural bio...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.100.5.1328
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:IV fluid represents a basic therapeutic intervention for septic shock. Unfortunately, the optimal administration of IV fluid to maximize patient outcomes and prevent complications is largely unknown. METHODS:Patients with septic shock admitted to the medical ICUs of Barnes-Jewish Hospital (January to Decemb...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.15-1525
更新日期:2015-12-01 00:00:00
abstract:STUDY OBJECTIVES:Patients with COPD have an increased sympathetic modulation and reduced baroreflex sensitivity (BRS). Therefore, we studied the effects of breathing 31% supplemental oxygen (SuppO(2)) on autonomic modulation in a group of COPD patients. DESIGN:We measured autonomic modulation before and during the adm...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.118.3.691
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:While the beneficial effect of exercise capacity on mortality is well-accepted, its effect on health-care costs remains uncertain. This study investigates the relationship between exercise capacity and health-care costs. METHODS:The Veterans Affairs Health Care System recently implemented a Decision Support...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.126.2.608
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:Eosinophils contain granule proteins such as eosinophil cationic protein (ECP) that have proinflammatory effects on airways. ECP may be released on activation of eosinophils into the plasma and is widely used as a marker of bronchial hyperreactivity and allergic inflammation. Environmental factors as well as...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.121.4.1111
更新日期:2002-04-01 00:00:00
abstract::Solitary extramedullary plasmacytomas are uncommon neoplasms. They occur most frequently in the upper aerodigestive tract and account for 4% of the nonepithelial tumors in this site. The evolution of a plasmacytoma is unsteady and symptoms at presentation have included dystonia, dysphagia, oral pain, cough, and dyspne...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.109.6.1657
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Data on patients with cancer who have a prolonged length of stay (LOS) in the ICU are scarce. The aim of the present study was to evaluate the characteristics and the outcomes of cancer patients with life-threatening complications with an ICU stay > or = 21 days. METHODS:A cohort study performed at a 10-bed...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-0359
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:Analysis of laryngotracheoscopic findings of the upper airway tract following percutaneous tracheostomy using the technique according to Griggs. DESIGN:Retrospective cohort study PATIENTS:Nineteen of 32 long-term surviving patients (mean follow-up duration, 17 months; range, 11 to 23 months) underwent a mod...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.1.206
更新日期:2002-07-01 00:00:00
abstract::A group of 14 patients with mitral valve prolapse syndrome was referred for coronary angiographic study. The group was selected on the basis that all members had recurrent chest pain as their chief complaint and all had interpreted their chest pain as serious enough to warrant at lest two previous emergency visits to ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.79.4.449
更新日期:1981-04-01 00:00:00
abstract::Chronic cough is a common symptom with significant morbidity. We report a case of a 51-year-old woman who presented with chronic cough. She recently had received a diagnosis of glaucoma and had started receiving therapy with topical latanoprost. The onset of cough coincided with the use of latanoprost. We performed a ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.09-0070
更新日期:2009-11-01 00:00:00
abstract:STUDY OBJECTIVES:To determine patterns in asbestos-induced lung diseases found in older, less exposed workers. DESIGN:Review of a database evaluating lung function, smoking status, form of asbestos-induced lung disease, and radiograph abnormalities. SETTING:Outpatient clinic. PARTICIPANTS:A total of 3383 asbestos-ex...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.125.2.744
更新日期:2004-02-01 00:00:00
abstract::A female patient was treated with high-dose inhaled fluticasone propionate for her asthma. Over 2 years, she developed features of Cushing's syndrome with proximal myopathy, osteopenia, hypertension, depressive psychosis, and cushingoid appearance. She had biochemical evidence of marked adrenal suppression with a 9:00...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.117.2.593
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVE:To assess pulmonologists' use, training in the use, and knowledge base of the drug cyclophosphamide. DESIGN:Survey through questionnaire. Testing of knowledge base before and after instructional conference. PARTICIPANTS AND METHODS:Pulmonologists (94 attendings, 31 fellows), selected randomly at the 1996 an...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.116.5.1159
更新日期:1999-11-01 00:00:00
abstract:STUDY OBJECTIVES:The physicians who initially evaluate patients with non-small cell lung cancer (NSCLC) strongly impact the course of therapy. Their beliefs in treatment and prognosis may contribute to practices of variable quality and appropriateness. We sought to better describe beliefs among pulmonologists and thora...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.118.1.129
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVES:Studies documenting the increased incidence of exercise-induced bronchospasm (EIB) in figure skaters have employed a method that incorporates on-ice exercise with rink-side spirometry. The literature suggests that bronchial provocation challenge testing is better than exercise testing for identifying EIB. To...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.115.3.649
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:COPD is characterized by chronic inflammation. In vitro and ex vivo observations suggest that this inflammatory response is partially resistant to the effect of corticosteroids and that low-dose theophylline can restore this response via enhancement of histone deacetylase (HDAC) activity. Whether this occurs...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.chest.2016.04.011
更新日期:2016-07-01 00:00:00
abstract::We investigated the utility of a noninvasive respiratory inductive plethysmograph (RIP) to continuously monitor and record the breathing pattern of 44 patients who had been mechanically ventilated. Seven patients deteriorated on intermittent mandatory ventilatory rate of zero; seven deteriorated within 48 h following ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.94.2.254
更新日期:1988-08-01 00:00:00
abstract::We measured the surface temperature of the tumors in 27 patients with primary lung cancer, using a flexible bronchofiberscope and a thermometer made from chromel-constantan. The thermometer was inserted into the aspiration channel of the bronchofiberscope, and temperature was studied under bronchofiberscopic located i...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.81.1.62
更新日期:1982-01-01 00:00:00
abstract::The determination of effective dynamic and static relationships between pressure and volume aided in the diagnosis of pulmonary disease, its course, and the effects of therapy in 22 patients receiving continuous mechanical ventilation. These measurements were made on multiple occasions early in the course of mechanica...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.70.6.740
更新日期:1976-12-01 00:00:00