摘要

Pneumonia is a leading cause of mortality. Severity-assessment scores in pneumonia guide treatment crucially, but the ones currently in existence are limited in their use. Community-based studies demonstrated the association between pre-existing low estimated glomerular filtration rate (eGFR) and outcomes in pneumonia. However, whether a single emergency department-eGFR measurement could predict outcomes in pneumonia remains unclear. This retrospective cohort study included 1554 patients hospitalized with pneumonia. The predictor was the first eGFR measurement. Outcomes included mortality, intensive care unit (ICU) admission, durations of hospital and ICU stay, and ventilator use. Receiver operating characteristic curves was used to determine optimal cutoff values to predict mortality. Of 1554 patients, 263 had chronic kidney disease, demonstrated higher C-reactive protein and SMART-COP scores, and had more multilobar pneumonia, acute kidney injury, ICU admission, and mortality. Patients with higher pneumonia severity scores tended to have lower eGFR. For predicting in-hospital mortality, the optimal eGFR cutoff value was 56 mL/min/1.73 m2. eGFR < 56 mL/min/1.73 m2 had an odds ratio of 2.5 (95% confidence interval, 1.6–4.0) for mortality by multivariate logistic regression. In Conclusion, eGFR < 56 mL/min/1.73 m2 is an independent predictor of mortality, indicating that even mild renal impairment affects the outcome of pneumonia adversely.
原文英語
文章編號8478
期刊Scientific Reports
9
發行號1
DOIs
出版狀態已發佈 - 十二月 1 2019

指紋

Point-of-Care Systems
Glomerular Filtration Rate
Pneumonia
Mortality
Intensive Care Units
Mechanical Ventilators
Hospital Mortality
Chronic Renal Insufficiency
Acute Kidney Injury
ROC Curve
C-Reactive Protein
Hospital Emergency Service
Cohort Studies
Retrospective Studies
Logistic Models
Odds Ratio
Confidence Intervals
Kidney

ASJC Scopus subject areas

  • General

引用此文

Point of Care eGFR and the Prediction of Outcomes in Pneumonia. / Suk, Chi won; Hsu, Shih chang; Chen, Chun you; Hsieh, Hui ling; Kuo, Hsiao tung; Hsu, Yuan pin; Sue, Yuh mou; Chen, Tso Hsiao; Lin, Feng yen; Shih, Chun ming; Chen, Jaw wen; Lin, Shing jong; Huang, Po hsun; Liu, Chung te.

於: Scientific Reports, 卷 9, 編號 1, 8478, 01.12.2019.

研究成果: 雜誌貢獻文章

Suk, Chi won ; Hsu, Shih chang ; Chen, Chun you ; Hsieh, Hui ling ; Kuo, Hsiao tung ; Hsu, Yuan pin ; Sue, Yuh mou ; Chen, Tso Hsiao ; Lin, Feng yen ; Shih, Chun ming ; Chen, Jaw wen ; Lin, Shing jong ; Huang, Po hsun ; Liu, Chung te. / Point of Care eGFR and the Prediction of Outcomes in Pneumonia. 於: Scientific Reports. 2019 ; 卷 9, 編號 1.
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AU - Hsu, Yuan pin

AU - Sue, Yuh mou

AU - Chen, Tso Hsiao

AU - Lin, Feng yen

AU - Shih, Chun ming

AU - Chen, Jaw wen

AU - Lin, Shing jong

AU - Huang, Po hsun

AU - Liu, Chung te

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AB - Pneumonia is a leading cause of mortality. Severity-assessment scores in pneumonia guide treatment crucially, but the ones currently in existence are limited in their use. Community-based studies demonstrated the association between pre-existing low estimated glomerular filtration rate (eGFR) and outcomes in pneumonia. However, whether a single emergency department-eGFR measurement could predict outcomes in pneumonia remains unclear. This retrospective cohort study included 1554 patients hospitalized with pneumonia. The predictor was the first eGFR measurement. Outcomes included mortality, intensive care unit (ICU) admission, durations of hospital and ICU stay, and ventilator use. Receiver operating characteristic curves was used to determine optimal cutoff values to predict mortality. Of 1554 patients, 263 had chronic kidney disease, demonstrated higher C-reactive protein and SMART-COP scores, and had more multilobar pneumonia, acute kidney injury, ICU admission, and mortality. Patients with higher pneumonia severity scores tended to have lower eGFR. For predicting in-hospital mortality, the optimal eGFR cutoff value was 56 mL/min/1.73 m2. eGFR < 56 mL/min/1.73 m2 had an odds ratio of 2.5 (95% confidence interval, 1.6–4.0) for mortality by multivariate logistic regression. In Conclusion, eGFR < 56 mL/min/1.73 m2 is an independent predictor of mortality, indicating that even mild renal impairment affects the outcome of pneumonia adversely.

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