title: Computed tomography findings in septic patients with acute respiratory distress syndrome: correlation with survival and pulmonary versus extrapulmonary septic focus.
abstract: OBJECTIVE
  The objective of this study was to evaluate computed tomography (CT) findings in patients with sepsis with unknown inflammatory focus and acute respiratory distress syndrome.
  
  
  METHODS
  Acute respiratory distress syndrome findings on CT of 36 patients with sepsis were graded on a 6-point scale, and the percentage of affected lung was estimated. Resulting CT scores were correlated to intensive care scores and survival.
  
  
  RESULTS
  Forty-four percent of the patients died, revealing a significantly higher CT score than survivors (P = 0.01). Survivors showed larger areas of unaffected lung (P < 0.001), whereas patients with fatal outcome had more ground-glass opacities (P = 0.002; sensitivity, 73%; specificity, 57%) and traction bronchiectasis (P = 0.009; sensitivity, 54%; specificity, 68%). Pulmonary findings on CT did not allow discriminating between a pulmonary and extrapulmonary focus. No significant coherence between CT score and intensive care scores could be revealed.
  
  
  CONCLUSIONS
  A CT scoring system based on pulmonary findings in patients with sepsis with acute respiratory distress syndrome comprises prognostic implications in terms of the patients' survival.
authors.affiliation: Klinik für Radiologie, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany. lars.stelter@charite.de
authors.forename: Lars
authors.initials: L
authors.lastname: Stelter
authors.forename: Ingo
authors.initials: I
authors.lastname: Steffen
authors.forename: Jens G
authors.initials: JG
authors.lastname: Pinkernelle
authors.forename: Vera
authors.initials: V
authors.lastname: von Dossow-Hanfstingl
authors.forename: Marc
authors.initials: M
authors.lastname: Kastrup
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Christian
authors.initials: C
authors.lastname: Grieser
mesh_terms: D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging* / Q000401:mortality*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000000981:diagnostic imaging* / Q000401:mortality*; D013223:Statistics as Topic; D016019:Survival Analysis; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*