title: Minor criteria of Infectious Disease Society Of America/American Thoracic Society for severe community-acquired pneumonia can predict delayed treatment response.
abstract: The purpose of this study was to investigate the clinical aspects of patients satisfying the Infectious Disease Society of America/American Thoracic Society (IDSA/ATS) minor severity criteria, focusing on their treatment response to empirical antibiotics. In total, 381 community-acquired pneumonia (CAP) patients who did not require mechanical ventilation or vasopressors at admission were enrolled, and 50 (13.1%) satisfied the minor severity criteria (i.e. , minor severe CAP [minor-SCAP]). The rates of new complication events and clinical treatment failure were significantly higher in the minor-SCAP group than in the control group (30.0% vs 2.1%, P < 0.001, and 42.0% vs 10.6%, P < 0.001, respectively), and the time to reach clinical stability was longer in the minor-SCAP group (8 days vs 3 days, P < 0.001). In a multivariate model, minor severity criteria (≥ 3) were significantly associated with treatment failure (odds ratio, 2.838; 95% confidence interval, 1.216 to 6.626), and for predicting treatment failure the value of the area under the receiver operating characteristic curve for minor criteria was 0.731, similar to other established scoring methods. The IDSA/ATS minor severity criteria can predict delayed treatment response and clinical treatment failure.
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Lung Research Institute of Hallym University, Chuncheon, Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Park
authors.forename: Sunghoon
authors.initials: S
authors.lastname: Park
authors.forename: Myung Goo
authors.initials: MG
authors.lastname: Lee
authors.forename: Dong-Gyu
authors.initials: DG
authors.lastname: Kim
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
authors.forename: Changhwan
authors.initials: C
authors.lastname: Kim
authors.forename: Chang Youl
authors.initials: CY
authors.lastname: Lee
authors.forename: Yong Bum
authors.initials: YB
authors.lastname: Park
authors.forename: Ki-Suck
authors.initials: KS
authors.lastname: Jung
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019540:Area Under Curve; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011014:Pneumonia / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D011237:Predictive Value of Tests; D012372:ROC Curve; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents