title: The interrelations of radiologic findings and mechanical ventilation in community acquired pneumonia patients admitted to the intensive care unit: a multicentre retrospective study.
abstract: BACKGROUND
  We evaluated patients admitted to the intensive care units with the diagnosis of community acquired pneumonia (CAP) regarding initial radiographic findings.
  
  
  METHODS
  A multicenter retrospective study was held. Chest x ray (CXR) and computerized tomography (CT) findings and also their associations with the need of ventilator support were evaluated.
  
  
  RESULTS
  A total of 388 patients were enrolled. Consolidation was the main finding on CXR (89%) and CT (80%) examinations. Of all, 45% had multi-lobar involvement. Bilateral involvement was found in 40% and 44% on CXR and CT respectively. Abscesses and cavitations were rarely found. The highest correlation between CT and CXR findings was observed for interstitial involvement. More than 80% of patients needed ventilator support. Noninvasive mechanical ventilation (NIV) requirement was seen to be more common in those with multi-lobar involvement on CXR as 2.4-fold and consolidation on CT as 47-fold compared with those who do not have these findings. Invasive mechanical ventilation (IMV) need increased 8-fold in patients with multi-lobar involvement on CT.
  
  
  CONCLUSIONS
  CXR and CT findings correlate up to a limit in terms of interstitial involvement but not in high percentages in other findings. CAP patients who are admitted to the ICU are severe cases frequently requiring ventilator support. Initial CT and CXR findings may indicate the need for ventilator support, but the assumed ongoing real practice is important and the value of radiologic evaluation beyond clinical findings to predict the mechanical ventilation need is subject for further evaluation with large patient series.
authors.forename: Hakan
authors.initials: H
authors.lastname: Erdem
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ankara Atatürk Training & Research Hospital, Yildirim Beyazit University, Bilkent Ankara, Turkey. drztufan@yahoo.com.
authors.forename: Zeliha
authors.initials: Z
authors.lastname: Kocak-Tufan
authors.forename: Omer
authors.initials: O
authors.lastname: Yilmaz
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Karakurt
authors.forename: Aykut
authors.initials: A
authors.lastname: Cilli
authors.forename: Hulya
authors.initials: H
authors.lastname: Turkan
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yazicioglu-Mocin
authors.forename: Nalan
authors.initials: N
authors.lastname: Adıguzel
authors.forename: Gokay
authors.initials: G
authors.lastname: Gungor
authors.forename: Canturk
authors.initials: C
authors.lastname: Taşcı
authors.forename: Gulden
authors.initials: G
authors.lastname: Yilmaz
authors.forename: Oral
authors.initials: O
authors.lastname: Oncul
authors.forename: Aygul
authors.initials: A
authors.lastname: Dogan-Celik
authors.forename: Ozcan
authors.initials: O
authors.lastname: Erdemli
authors.forename: Nefise
authors.initials: N
authors.lastname: Oztoprak
authors.forename: Yakup
authors.initials: Y
authors.lastname: Tomak
authors.forename: Asuman
authors.initials: A
authors.lastname: Inan
authors.forename: Demet
authors.initials: D
authors.lastname: Tok
authors.forename: Sibel
authors.initials: S
authors.lastname: Temur
authors.forename: Hafize
authors.initials: H
authors.lastname: Oksuz
authors.forename: Ozgur
authors.initials: O
authors.lastname: Senturk
authors.forename: Unase
authors.initials: U
authors.lastname: Buyukkocak
authors.forename: Fatma
authors.initials: F
authors.lastname: Yilmaz-Karadag
authors.forename: Derya
authors.initials: D
authors.lastname: Ozturk-Engin
authors.forename: Dilek
authors.initials: D
authors.lastname: Ozcengiz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karakas
authors.forename: Hayati
authors.initials: H
authors.lastname: Bilgic
authors.forename: Hakan
authors.initials: H
authors.lastname: Leblebicioglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000473:pathology* / Q000628:therapy*; D013902:Radiography, Thoracic; D012121:Respiration, Artificial; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult