Accuracy of the clinical pulmonary infection ...
Document type :
Article dans une revue scientifique
Permalink :
Title :
Accuracy of the clinical pulmonary infection score to differentiate ventilator-associated tracheobronchitis from ventilator-associated pneumonia
Author(s) :
Gaudet, Alexandre [Auteur]
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Martin-Loeches, Ignacio [Auteur]
Institut d'Investigacions Biomèdiques August Pi i Sunyer [IDIBAPS]
St James's University Hospital
Povoa, Pedro [Auteur]
Universidade Nova de Lisboa = NOVA University Lisbon [NOVA]
Rodriguez, Alejandro [Auteur]
Salluh, Jorge [Auteur]
D'Or Institute for Research and Education [Rio de Janeiro]
Duhamel, Alain [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Nseir, Saad [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Martin-Loeches, Ignacio [Auteur]
Institut d'Investigacions Biomèdiques August Pi i Sunyer [IDIBAPS]
St James's University Hospital
Povoa, Pedro [Auteur]
Universidade Nova de Lisboa = NOVA University Lisbon [NOVA]
Rodriguez, Alejandro [Auteur]
Salluh, Jorge [Auteur]
D'Or Institute for Research and Education [Rio de Janeiro]
Duhamel, Alain [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Nseir, Saad [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Journal title :
Annals of Intensive Care
Abbreviated title :
Ann. Intensive Care
Volume number :
10
Publisher :
Springer Science and Business Media LLC
Publication date :
2020-08-03
ISSN :
2110-5820
English keyword(s) :
Mechanical ventilation
Lower respiratory tract infection
Tracheobronchitis
Pneumonia
CPIS
Lower respiratory tract infection
Tracheobronchitis
Pneumonia
CPIS
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
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 ...
Show more >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.Show less >
Show more >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.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CNRS
CNRS
Collections :
Research team(s) :
Glycobiology in fungal Pathogenesis and Clinical Applications
Submission date :
2021-07-15T09:07:02Z
2021-07-16T07:15:21Z
2021-07-16T07:15:21Z
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