A predictive model for the treatment approach to community-acquired pneumonia in patients needing ICU admission.
OBJECTIVE
To create a predictive model for the treatment approach to community-acquired pneumonia (CAP) in patients needing Intensive Care Unit (ICU) admission.


METHODS
Multicenter prospective study.


METHODS
Twenty-six Spanish ICUs.


METHODS
One hundred seven patients with CAP, all of them with accurate etiological diagnosis, divided in three groups according to their etiology in typical (bacterial pneumonia), Legionella and other atypical (Mycoplasma, Chlamydia spp. and virus). For the multivariate analysis we grouped Legionella and other atypical etiologies in the same category.


METHODS
We recorded 34 variables including clinical characteristics, risk factors and radiographic pattern. We used a multivariate logistic regression analysis to find out a predictive model.


RESULTS
We have the complete data in 70 patients. Four variables: APACHE II, (categorized as a dummy variable) serum sodium and phosphorus and "length of symptoms" gave an accurate predictive model (c = 0.856). From the model we created a score that predicts typical pneumonia with a sensitivity of 90.2% and specificity 72.4%.


CONCLUSIONS
Our model is an attempt to help in the treatment approach to CAP in ICU patients based on a predictive model of basic clinical and laboratory information. Further studies, including larger numbers of patients, should validate and investigate the utility of this model in different clinical settings.
Olaechea
P M
PM
Hospital de Galdakao, Galdakao, Vizcaya, Spain.
Quintana
J M
JM
Gallardo
M S
MS
Insausti
J
J
Maraví
E
E
Alvarez
B
B
D018806:APACHE; D000328:Adult; D000368:Aged; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy*; D003422:Critical Care; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012680:Sensitivity and Specificity