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

2020-12-01Artigo científico Acesso aberto
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dc.contributor.authorGaudet, Alexandre
dc.contributor.authorMartin-Loeches, Ignacio
dc.contributor.authorPovoa, Pedro
dc.contributor.authorPovoa, Pedro
dc.contributor.authorRodriguez, Alejandro
dc.contributor.authorSalluh, Jorge
dc.contributor.authorDuhamel, Alain
dc.contributor.authorNseir, Saad
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblSpringer Verlag
dc.date.accessioned2020-09-09T02:37:24Z
dc.date.available2020-09-09T02:37:24Z
dc.date.issued2020-12-01
dc.description.abstractBackground: 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.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent935441
dc.identifier.doi10.1186/s13613-020-00721-4
dc.identifier.issn2110-5820
dc.identifier.otherPURE: 19741319
dc.identifier.otherPURE UUID: f852b376-c710-4611-9ba2-e45c97fc2061
dc.identifier.otherScopus: 85088831450
dc.identifier.otherPubMed: 32748025
dc.identifier.otherWOS: 000560375400002
dc.identifier.urihttp://hdl.handle.net/10362/103789
dc.identifier.urlhttps://www.scopus.com/pages/publications/85088831450
dc.language.isoeng
dc.peerreviewedyes
dc.subjectCPIS
dc.subjectLower respiratory tract infection
dc.subjectMechanical ventilation
dc.subjectPneumonia
dc.subjectTracheobronchitis
dc.subjectCritical Care and Intensive Care Medicine
dc.titleAccuracy of the clinical pulmonary infection score to differentiate ventilator-associated tracheobronchitis from ventilator-associated pneumoniaen
dc.typejournal article
degois.publication.issue1
degois.publication.titleAnnals of Intensive Care
degois.publication.volume10
dspace.entity.typePublication
person.familyNamePovoa
person.givenNamePedro
person.identifier.ciencia-id0C16-5CF9-9238
person.identifier.orcid0000-0002-7069-7304
person.identifier.scopus-author-id6602772147
rcaap.rightsopenAccess
relation.isAuthorOfPublication04ec38ba-be1e-46e5-8007-0e65a557d0f4
relation.isAuthorOfPublication.latestForDiscovery04ec38ba-be1e-46e5-8007-0e65a557d0f4

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