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Amsterdam 2011
Sunday, 25.09.2011
The new clinical spectrum of lung diseases: from bronchi to pleura
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Contribution of clinical pulmonary infection score in the diagnosis of hospital acquired pneumonia
B. Basarik, P. Ozdemir, M. S. Tasbakan, O. Kacmaz Basoglu, A. Gurgun, F. Bacakoglu (Istanbul, Turkey)
Source:
Annual Congress 2011 - The new clinical spectrum of lung diseases: from bronchi to pleura
Session:
The new clinical spectrum of lung diseases: from bronchi to pleura
Session type:
Poster Discussion
Number:
490
Disease area:
Respiratory infections
Abstract
Introduction and Aim
Clinical pulmonary infection score (CPIS) is a scoring system calculated by symptoms and signs of pneumonia, that is used in the diagnosis and management of hospital acquired pneumonia (HAP). In this study, the contribution of CPIS for diagnosis of HAP was investigated in intensive care unit (ICU) patients.
Methods
The ICU patients followed-up between February 2008 and September 2010 were assessed retrospectively. Hospital acquired pneumonia was diagnosed by quantitative endotracheal aspirate (ETA). CPIS was calculated on 3
rd
and 7
th
days of ICU admission. The correlations of CPIS with concurrent ETA cultures and laboratory markers of infection were assessed.
Results
Out of 240 patients (165 men, mean age 58.2±16.6 yrs) included in the study, ETA cultures were positive in 61 patients (25.4%) on 3
rd
day, and in 59 patients (24.6%) on 7
th
day. CPIS was found higher in patients with ETA culture positive (5.0±2.3 vs. 3.5±2.1 on 3
rd
day, p<0.0001; 5.2±2.6 vs. 3.6±2.9 on 7
th
day, p<0.0001). Sensitivity and specificity ratios of CPIS with a threshold level of 6.5 in diagnosis of HAP were 26.2% and 92.3% for 3
rd
day; 30.5% and 91.9% for 7
th
day, respectively. On 3
rd
and 7
th
days, there were positive correlations between CPIS and C-reactive protein (CRP) levels (p=0.002 and p=0.001, respectively); and also between CPIS and procalcitonin (PCT) levels (p=0.012 and p<0.0001, respectively).
Conclusion
Clinical pulmonary infection score can be used instead of infection markers like CRP and PCT in the diagnosis of hospital acquired pneumonia.
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B. Basarik, P. Ozdemir, M. S. Tasbakan, O. Kacmaz Basoglu, A. Gurgun, F. Bacakoglu (Istanbul, Turkey). Contribution of clinical pulmonary infection score in the diagnosis of hospital acquired pneumonia. Eur Respir J 2011; 38: Suppl. 55, 490
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