Association between delay in intensive care unit admission and the host response in patients with community-acquired pneumonia

Pereverzeva, Liza; Uhel, Fabrice; Sengers, Hessel Peters; Cremer, Olaf L.; Schultz, Marcus J.; Bonten, Marc; Scicluna, Brendon P.; Poll, Tom van der

doi:10.1186/s13613-021-00930-5

Cited by 8 publications

(5 citation statements)

References 45 publications

(71 reference statements)

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“…Early determination of the disease severity of AP in the more fragile population aged 65 and over also enables the need for intensive care to be evaluated. Belated admission of critically ill patients to intensive care is known to increase mortality 28,29 . Many scoring systems such as RANSON 20 , APACHE II 30 , CTSI 19 , BISAP 21 , Glasgow (Imrie's) 31 , and Harmless Acute Pancreatitis Score 32 19,33 .…”

Section: Discussionmentioning

confidence: 99%

65 yaş üstü hastalarda puanlama sistemlerinin şiddetli akut pankreatiti ve mortaliteyi erken öngörme açısından değerlendirilmesi

Acehan

Satar

Gülen

et al. 2022

Cukurova Medical Journal

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Purpose: The aim of this study is to investigate the power of disease severity scores to predict the development of Severe Acute Pancreatitis (SAP) and mortality in the early period over 65 years old diagnosed with acute pancreatitis in the emergency department. Materials and Methods: We calculated RANSON (on admission) and Computed Tomography Severity Index (CTSI) in addition to Bedside Index for Severity in Acute Pancreatitis (BISAP) score on admission to the emergency department. Results: One hundred and sixty patients (46.9% over 80 years of age) were included in the study. We observed statistically higher length of hospitalization, longer duration of stay in the intensive care unit, SAP and higher mortality in patients over 80 years of age. When we examined the ROC curve, we determined that the AUC values of the BISAP score were highest in both SAP and mortality estimation (AUC: 0.911, 95% CI 0.861-0.962; AUC: 0.918, 95% CI 0.864-0.9722, respectively). Binary logistic analysis indicated a 4.7-fold increased risk for SAP and a 12.3-fold increased mortality for each unit increase in BISAP score value. Conclusion: BISAP may be a good predictor for SAP and mortality estimation on admission to the emergency department in patients over 65 years of age with acute pancreatitis.

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Section: Discussionmentioning

confidence: 99%

65 yaş üstü hastalarda puanlama sistemlerinin şiddetli akut pankreatiti ve mortaliteyi erken öngörme açısından değerlendirilmesi

Acehan

Satar

Gülen

et al. 2022

Cukurova Medical Journal

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“…Delayed ICU admission in patients with CAP has been shown to increase mortality, especially in elderly patients, patients with multiple comorbidities, and immunocompromised patients [1,46,47]. Timely appropriate antibiotic therapy and delay in ICU admission are two important factors that contribute to the better or worse outcome in CAP patients [48][49][50].…”

Section: Intensive Care Unit Admission Criteria and Clinical Stabilit...mentioning

confidence: 99%

Ten Issues for Updating in Community-Acquired Pneumonia: An Expert Review

Candel,

Salavert,

Basaras

et al. 2023

JCM

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Community-acquired pneumonia represents the third-highest cause of mortality in industrialized countries and the first due to infection. Although guidelines for the approach to this infection model are widely implemented in international health schemes, information continually emerges that generates controversy or requires updating its management. This paper reviews the most important issues in the approach to this process, such as an aetiologic update using new molecular platforms or imaging techniques, including the diagnostic stewardship in different clinical settings. It also reviews both the Intensive Care Unit admission criteria and those of clinical stability to discharge. An update in antibiotic, in oxygen, or steroidal therapy is presented. It also analyzes the management out-of-hospital in CAP requiring hospitalization, the main factors for readmission, and an approach to therapeutic failure or rescue. Finally, the main strategies for prevention and vaccination in both immunocompetent and immunocompromised hosts are reviewed.

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“…Severe pneumonia is a subset of pneumonia that is associated with higher mortality and morbidity, and requires intensive care unit (ICU) admission ( 5 ), which is defined by the presence of one or more of the following criteria: respiratory failure, septic shock, multiorgan dysfunction, or complicated pleural effusion ( 6 ). The mortality rate of severe pneumonia in older adult patients can reach up to 50%, depending on the underlying conditions and the causative pathogens ( 7 ). Therefore, it is crucial to identify the risk factors and develop a prediction model for severe pneumonia in older adult patients, in order to improve the diagnosis and management of this condition.…”

Section: Introductionmentioning

confidence: 99%

Risk factors analysis and prediction model construction for severe pneumonia in older adult patients

Liu,

Jiang,

Zhang

et al. 2024

Front. Public Health

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ObjectivePneumonia is a common and serious infectious disease that affects the older adult population. Severe pneumonia can lead to high mortality and morbidity in this group. Therefore, it is important to identify the risk factors and develop a prediction model for severe pneumonia in older adult patients.MethodIn this study, we collected data from 1,000 older adult patients who were diagnosed with pneumonia and admitted to the intensive care unit (ICU) in a tertiary hospital. We used logistic regression and machine learning methods to analyze the risk factors and construct a prediction model for severe pneumonia in older adult patients. We evaluated the performance of the model using accuracy, sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and calibration plot.ResultWe found that age, comorbidities, vital signs, laboratory tests, and radiological findings were associated with severe pneumonia in older adult patients. The prediction model had an accuracy of 0.85, a sensitivity of 0.80, a specificity of 0.88, and an AUC of 0.90. The calibration plot showed good agreement between the predicted and observed probabilities of severe pneumonia.ConclusionThe prediction model can help clinicians to stratify the risk of severe pneumonia in older adult patients and provide timely and appropriate interventions.

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Association between delay in intensive care unit admission and the host response in patients with community-acquired pneumonia

Cited by 8 publications

References 45 publications

65 yaş üstü hastalarda puanlama sistemlerinin şiddetli akut pankreatiti ve mortaliteyi erken öngörme açısından değerlendirilmesi

65 yaş üstü hastalarda puanlama sistemlerinin şiddetli akut pankreatiti ve mortaliteyi erken öngörme açısından değerlendirilmesi

Ten Issues for Updating in Community-Acquired Pneumonia: An Expert Review

Risk factors analysis and prediction model construction for severe pneumonia in older adult patients

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