The aim of this study was to determine if severity assessment tools (general severity of illness and community-acquired pneumonia specific scores) can be used to guide decisions for patients admitted to the intensive care unit (ICU) due to pandemic influenza A pneumonia. A prospective, observational, multicentre study included 265 patients with a mean age of 42 (±16.1) years and an ICU mortality of 31.7%. On admission to the ICU, the mean pneumonia severity index (PSI) score was 103.2 ± 43.2 points, the CURB-65 score was 1.7 ± 1.1 points and the PIRO-CAP score was 3.2 ± 1.5 points. None of the scores had a good predictive ability: area under the ROC for PSI, 0.72 (95% CI, 0.65-0.78); CURB-65, 0.67 (95% CI, 0.59-0.74); and PIRO-CAP, 0.64 (95% CI, 0.56-0.71). The PSI score (OR, 1.022 (1.009-1.034), p 0.001) was independently associated with ICU mortality; however, none of the three scores, when used at ICU admission, were able to reliably detect a low-risk group of patients. Low risk for mortality was identified in 27.5% of patients using PIRO-CAP, but above 40% when using PSI (I-III) or CURB65 (<2). Observed mortality was 13.7%, 13.5% and 19.4%, respectively. Pneumonia-specific scores undervalued severity and should not be used as instruments to guide decisions in the ICU.
Severity assessment tools in ICU patients with 2009 influenza A (H1N1) pneumonia / Pereira, J. M; Moreno, R. P; Matos, R; Rhodes, A; Martin Loeches, I; Cecconi, M; Lisboa, T; Rello, J.. - In: CLINICAL MICROBIOLOGY AND INFECTION. - ISSN 1469-0691. - 18:10(2012), pp. 1040-8-1048. [10.1111/j.1469-0691.2011.03736.x]
Data di pubblicazione: | 2012 | |
Titolo: | Severity assessment tools in ICU patients with 2009 influenza A (H1N1) pneumonia | |
Autore/i: | Pereira, J. M; Moreno, R. P; Matos, R; Rhodes, A; Martin Loeches, I; Cecconi, M; Lisboa, T; Rello, J. | |
Autore/i UNIMORE: | ||
Digital Object Identifier (DOI): | http://dx.doi.org/10.1111/j.1469-0691.2011.03736.x | |
Rivista: | ||
Volume: | 18 | |
Fascicolo: | 10 | |
Pagina iniziale: | 1040-8 | |
Pagina finale: | 1048 | |
Codice identificativo ISI: | WOS:000308579400029 | |
Codice identificativo Scopus: | 2-s2.0-84866181949 | |
Codice identificativo Pubmed: | 22264290 | |
Citazione: | Severity assessment tools in ICU patients with 2009 influenza A (H1N1) pneumonia / Pereira, J. M; Moreno, R. P; Matos, R; Rhodes, A; Martin Loeches, I; Cecconi, M; Lisboa, T; Rello, J.. - In: CLINICAL MICROBIOLOGY AND INFECTION. - ISSN 1469-0691. - 18:10(2012), pp. 1040-8-1048. [10.1111/j.1469-0691.2011.03736.x] | |
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pereiraClinMicro2012-SeverityH1N1.pdf | Versione dell'editore (versione pubblicata) | Open Access Visualizza/Apri |
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