Articles producció científica> Medicina i Cirurgia

Accuracy of the clinical pulmonary infection score to differentiate ventilator-associated tracheobronchitis from ventilator-associated pneumonia

  • Identification data

    Identifier: imarina:7238127
    Authors:
    Gaudet AMartin-Loeches IPovoa PRodriguez ASalluh JDuhamel ANseir S
    Abstract:
    © 2020, The Author(s). Background: Differentiating Ventilator-Associated Tracheobronchitis (VAT) from Ventilator-Associated Pneumonia (VAP) may be challenging for clinicians, yet their management currently differs. In this study, we evaluated the accuracy of the Clinical Pulmonary Infection Score (CPIS) to differentiate VAT and VAP. Methods: We performed a retrospective analysis based on the data from 2 independent prospective cohorts. Patients of the TAVeM database with a diagnosis of VAT (n = 320) or VAP (n = 369) were included in the derivation cohort. Patients admitted to the Intensive Care Centre of Lille University Hospital between January 1, 2016 and December 31, 2017 who had a diagnosis of VAT (n = 70) or VAP (n = 139) were included in the validation cohort. The accuracy of the CPIS to differentiate VAT from VAP was assessed within the 2 cohorts by calculating sensitivity and specificity values, establishing the ROC curves and choosing the best threshold according to the Youden index. Results: The areas under ROC curves of CPIS to differentiate VAT from VAP were calculated at 0.76 (95% CI [0.72–0.79]) in the derivation cohort and 0.67 (95% CI [0.6–0.75]) in the validation cohort. A CPIS value ≥ 7 was associated with the highest Youden index in both cohorts. With this cut-off, sensitivity and specificity were respectively found at 0.51 and 0.88 in the derivation cohort, and at 0.45 and 0.89 in the validation cohort. Conclusions: A CPIS value ≥ 7 reproducibly allowed to differentiate VAT from VAP with high specificity and PPV and moderate sensitivity and NPV in our derivation and validation cohorts.
  • Others:

    Author, as appears in the article.: Gaudet A; Martin-Loeches I; Povoa P; Rodriguez A; Salluh J; Duhamel A; Nseir S
    Department: Medicina i Cirurgia
    URV's Author/s: Rodríguez Oviedo, Alejandro Hugo
    Keywords: Tracheobronchitis Pneumonia Mechanical ventilation Lower respiratory tract infection Intensive-care-unit Diagnosis Cpis
    Abstract: © 2020, The Author(s). Background: Differentiating Ventilator-Associated Tracheobronchitis (VAT) from Ventilator-Associated Pneumonia (VAP) may be challenging for clinicians, yet their management currently differs. In this study, we evaluated the accuracy of the Clinical Pulmonary Infection Score (CPIS) to differentiate VAT and VAP. Methods: We performed a retrospective analysis based on the data from 2 independent prospective cohorts. Patients of the TAVeM database with a diagnosis of VAT (n = 320) or VAP (n = 369) were included in the derivation cohort. Patients admitted to the Intensive Care Centre of Lille University Hospital between January 1, 2016 and December 31, 2017 who had a diagnosis of VAT (n = 70) or VAP (n = 139) were included in the validation cohort. The accuracy of the CPIS to differentiate VAT from VAP was assessed within the 2 cohorts by calculating sensitivity and specificity values, establishing the ROC curves and choosing the best threshold according to the Youden index. Results: The areas under ROC curves of CPIS to differentiate VAT from VAP were calculated at 0.76 (95% CI [0.72–0.79]) in the derivation cohort and 0.67 (95% CI [0.6–0.75]) in the validation cohort. A CPIS value ≥ 7 was associated with the highest Youden index in both cohorts. With this cut-off, sensitivity and specificity were respectively found at 0.51 and 0.88 in the derivation cohort, and at 0.45 and 0.89 in the validation cohort. Conclusions: A CPIS value ≥ 7 reproducibly allowed to differentiate VAT from VAP with high specificity and PPV and moderate sensitivity and NPV in our derivation and validation cohorts.
    Thematic Areas: Saúde coletiva Medicina iii Medicina ii Medicina i Engenharias iv Critical care medicine Critical care and intensive care medicine Ciências biológicas ii
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: alejandrohugo.rodriguez@urv.cat
    Author identifier: 0000-0001-8828-5984
    Record's date: 2023-09-02
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-020-00721-4
    Papper original source: Annals Of Intensive Care. 10 (1): 101-
    APA: Gaudet A; Martin-Loeches I; Povoa P; Rodriguez A; Salluh J; Duhamel A; Nseir S (2020). Accuracy of the clinical pulmonary infection score to differentiate ventilator-associated tracheobronchitis from ventilator-associated pneumonia. Annals Of Intensive Care, 10(1), 101-. DOI: 10.1186/s13613-020-00721-4
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Article's DOI: 10.1186/s13613-020-00721-4
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2020
    Publication Type: Journal Publications
  • Keywords:

    Critical Care and Intensive Care Medicine,Critical Care Medicine
    Tracheobronchitis
    Pneumonia
    Mechanical ventilation
    Lower respiratory tract infection
    Intensive-care-unit
    Diagnosis
    Cpis
    Saúde coletiva
    Medicina iii
    Medicina ii
    Medicina i
    Engenharias iv
    Critical care medicine
    Critical care and intensive care medicine
    Ciências biológicas ii
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