Community acquired pneumonia (CAP) is a common condition and attributes to a significant amount of mortality and morbidity. In the United States of America, it is estimated that 5-6 million people suffer from CAP, 1.1 million people require to be admitted to hospitals and 60,000 deaths occur per year. 1,2 Recent studies have documented major cardiac complications in patients with CAP, particularly in patients requiring hospitalisation. 3 Multiple epidemiological studies [4][5][6][7] demonstrate that respiratory tract infections are associated with an increased risk for the development of an acute cardiac event (ACE). Thus, CAP and cardiac diseases are mutually aggravating conditions. There is a surge of interest in the association between major cardiac conditions and CAP, and therefore, the present study was done.
Material and MethodsThis was an observational study where we did a retrospective analysis of patients admitted with CAP between January 2011 and January 2012 at our tertiary care referral centre, in Bengaluru, Karnataka, India.We studied patients with the association of CAP and ACE on admission or any patient with CAP on admission, developing ACE after 48 to 72 hours of hospital stay. The patients who were admitted in the hospital with ACE but developed a CAP after 48 to 72
Introduction:The inflammation and fibrosis in diffuse parenchymal lung diseases (DPLDs) in varied proportions give rise to different patterns in radiology and histopathology. The radiological pattern on CT of the thorax most often allows us to make a diagnosis with varying levels of confidence, to optimize management. With a multidisciplinary team bringing the strengths of their individual domains of knowledge, clinical, radiological, histopathological, and in many cases rheumatological, the level of confidence in making this diagnosis increases, often to the stage where the diagnosis is most often right, is concordant with the diagnosis achieved at histopathology and therefore obviates the need for lung biopsy which carries its own costs and risks of complications. Our study emphasizes the role of the multidisciplinary team (MDT) in the management of DPLDs at a tertiary care referral center. Materials and Methods: Every case of DPLD presenting to our pulmonology department was discussed in an MDT meeting before subjecting them to any diagnostic intervention or therapy. A clinico-radiological diagnosis was made according to the 2002 ATS/ERS guidelines initially. Later an official ATS/ERS/JRS/ALAT statement on idiopathic pulmonary fibrosis and a 2013 ATS/ERS consensus for the classification and diagnosis of idiopathic interstitial pneumonia was used. The concordance in our study was defined as the percentage of histopathological diagnoses that were identical to the clinico-radiological MDT diagnosis prior to the biopsy. Results: A total of 434 patients with DPLDs were evaluated. The MDT suggested biopsy for only 38.7% (168/434) patients since the pattern was very clear in 266 (61.3%) cases. As not all patients consented to undergo the biopsy procedure when recommended, histopathology was obtained in 102 patients. The histological diagnosis was concordant with the initial MDT diagnosis in 80.3% (82/102) of samples. On an individual basis, connective tissue disease-interstitial lung disease and sarcoidosis showed the best concordance (87%). In idiopathic non-specific interstitial pneumonitis (NSIP) cases, the histopathological diagnosis concurred in only 53.3% (8/15), 761 | MURALI MOHAN et AL How to cite this article: Murali Mohan BV, Tousheed SZ, Manjunath PH, et al. Multidisciplinary team obviates biopsy in most patients with diffuse parenchymal lung diseases-A retrospective study from India.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.