Source: Annual Congress 2008 - Factors related to outcome of community-acquired pneumonia
Disease area: Respiratory infections

Abstract

Introduction: Blood pressure(BP) assessment is a central component of severity assessment for Community Acquired Pneumonia(CAP).
Methods: A 3 year prospective study of 1007 patients admitted with CAP comparing systolic BP (SBP), diastolic BP(DBP), mean arterial pressure(MAP) and pulse pressure(PP) on 30-day mortality and the requirement for mechanical ventilation and/or inotropic support(MV and/or IS).
Results: Admission SBP<90mmHg, DBP<60mmHg, MAP<70mmHg and PP<40mmHg are associated with increased 30-day mortality and the need for MV and/or IS. The relationship between each haemodynamic variable and 30-day mortality and need for MV and/or IS is shown in Table 1.

Table 1- Haemodynamic predictors of outcome in CAP

Prediction of 30-day mortality	PPV	NPV	Sensitivity	Specificity	AUC	p-value
SBP <90mmHg	30.7%	93.3%	41.1%	89.9%	0.70(0.67-0.74)	<0.0001
DBP ≤60mmHg	14.2%	92.8%	53.7%	64.7%	0.59(0.56-0.62)	0.006
MAP <70mmHg	18.3%	92.9%	43.3%	79.5%	0.64(0.61-0.67)	0.001
PP ≤40mmHg	14.2%	93.0%	53.6%	64.4%	0.60(0.56-0.63)	0.003
Prediction of MV/IS	PPV	NPV	Sensitivity	Specificity	AUC	p-value
SBP <90mmHg	35.4%	93.3%	44.6%	90.5%	0.70(0.67-0.73)	<0.0001
DBP ≤60mmHg	18.4%	94.3%	65.3%	66.2%	0.68(0.65-0.72)	<0.0001
MAP <70mmHg	24.5%	94.8%	57.7%	81.3%	0.69(0.66-0.72)	<0.0001
PP ≤40mmHg	15.3%	92.7%	54.4%	65.6%	0.59(0.56-0.63)	0.002

Conclusion: SBP is superior to other haemodynamic predictors of outcome in CAP.

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Citations should be made in the following way:
J. D. Chalmers, A. Singanayagam, A. T. Hill (Edinburgh, United Kingdom). Systolic blood pressure is superior to other haemodynamic predictors of severity in community acquired pneumonia. Eur Respir J 2008; 32: Suppl. 52, 1561

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