An evaluation of clinical stability criteria to predict hospital course in community-acquired pneumonia

A. R. Akram*, J. D. Chalmers, J. K. Taylor, J. Rutherford, A. Singanayagam, A. T. Hill

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

A number of different methods exist to assess clinical stability, a key component of pneumonia management. We compared the prognostic value of different stability criteria through a secondary analysis of the Edinburgh pneumonia study database. We studied four clinical stability criteria (Halm's criteria, the ATS criteria, CURB and 50% or more decrease in C-reactive protein from baseline). Outcomes included 30-day mortality, need for mechanical ventilation or vasopressor support (MV/VS), development of a complicated pneumonia, and a combined outcome of the above. A total of 1079 patients (49.8% male), with a median age of 68years (IQR 53-80), were included. Ninety-three patients (8.6%) died by day 30, 91 patients (8.4%) required MV/VS and 99 patients (9.2%) developed a complicated pneumonia. Patients with increasing severity of pneumonia on admission, assessed by both CURB-65 and PSI, took a progressively longer time to achieve clinical stability assessed by any method (p

Original languageEnglish
Pages (from-to)1174-1180
Number of pages7
JournalClinical Microbiology and Infection
Volume19
Issue number12
DOIs
Publication statusPublished - Dec 2013

Keywords

  • Community-acquired pneumonia
  • clinical stability
  • mortality
  • morbidity
  • C-REACTIVE PROTEIN
  • INFECTIOUS-DISEASES-SOCIETY
  • SEVERITY ASSESSMENT TOOLS
  • RISK-FACTORS
  • DISCHARGE
  • EFFICACY
  • INSTABILITY
  • VALIDATION
  • GUIDELINES
  • MORTALITY

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