title: Criteria for clinical stability in hospitalised patients with community-acquired pneumonia.
abstract: The American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) suggested two sets of criteria in 2001 and 2007 to define clinical stability in community-acquired pneumonia (CAP). The present study aimed to evaluate the level of agreement between these two sets of criteria and how well they can predict clinical outcomes. A retrospective cohort study was carried out of 487 consecutive patients hospitalised with CAP. Level of agreement was tested using a survival curve analysis, while prediction of outcomes at 30-day follow-up was evaluated through receiver operating characteristic (ROC) analysis. A discrepancy between ATS 2001 and ATS/IDSA 2007 criteria in identifying clinical stability was detected in 62% of the patients. The median (interquartile range) time to clinical stability was 2 (1-4) days based on ATS 2001 and 3 (2-5) days based on ATS/IDSA 2007 criteria (p = 0.012). The daily distribution of patients who reached clinical stability evaluated with both sets was different (p = 0.002). The ROC analysis showed an area under the curve of 0.705 for the ATS 2001 criteria and 0.714 for ATS/IDSA 2007 criteria (p = 0.645). ATS 2001 and ATS/IDSA 2007 criteria for clinical stability in hospitalised patients with CAP are clinically equivalent and both can be used in clinical practice as well as in clinical research.
authors.affiliation: Dept of Health Science, University of Milan Bicocca, AO San Gerardo, Monza, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Aliberti
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Zanaboni
authors.forename: Tim
authors.initials: T
authors.lastname: Wiemken
authors.forename: Ahmed
authors.initials: A
authors.lastname: Nahas
authors.forename: Srinivas
authors.initials: S
authors.lastname: Uppatla
authors.forename: Letizia Corinna
authors.initials: LC
authors.lastname: Morlacchi
authors.forename: Paula
authors.initials: P
authors.lastname: Peyrani
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasi
authors.forename: Julio
authors.initials: J
authors.lastname: Ramirez
mesh_terms: D000368:Aged; D017714:Community-Acquired Infections / Q000628:therapy*; D003371:Cough; D004417:Dyspnea; D005260:Female; D005334:Fever; D006339:Heart Rate; D006760:Hospitalization; D006787:Hospitals, Veterans; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D011014:Pneumonia / Q000628:therapy*; D056152:Respiratory Rate; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012955:Societies, Medical; D016896:Treatment Outcome