Severity assessment tools in ICU patients with 2009 Influenza A (H1N1) pneumonia

• Type: Article in International Scientific Journal
• Date: 2012

Authors

Pereira, JM (Author) Other; Moreno, RP (Author) Other; Matos, R (Author) Other; Rhodes, A (Author) Other; Martin Loeches, I (Author) Other; Cecconi, M (Author) Other; Lisboa, T (Author) Other; Rello, J (Author) Other; Granja C (Author) FMUP

Journal

Title: Clinical Microbiology and Infection

Vol. 18

Pages: 1040-1048

ISSN: 1198-743X

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 25 Citations

Scopus - 30 Citations

Other information

Authenticus ID: P-002-56M

DOI: 10.1111/j.1469-0691.2011.03736.x

Abstract (EN): Clin Microbiol Infect 2012; 18: 10401048 Abstract 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, 0.650.78); CURB-65, 0.67 (95% CI, 0.590.74); and PIRO-CAP, 0.64 (95% CI, 0.560.71). The PSI score (OR, 1.022 (1.0091.034), 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 (IIII) 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.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9