NDLI: Alveolar-arterial oxygen gradient, pneumonia severity index and outcomes in patients hospitalized with community acquired pneumonia.

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Alveolar-arterial oxygen gradient, pneumonia severity index and outcomes in patients hospitalized with community acquired pneumonia.

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Alveolar-arterial oxygen gradient, pneumonia severity index and outcomes in patients hospitalized with community acquired pneumonia.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Moammar, Mahmoud Q. Azam, Hamad M. Blamoun, Adel I. Rashid, Ashraf O. Ismail, Medhat Khan, M. Anees DeBari, Vincent A.
Description	Country affiliation: United States Author Affiliation: Moammar MQ ( Division of Pulmonary Diseases, Department of Medicine, School of Graduate Medical Education, Seton Hall University, South Orange, NJ 07079-2689, USA.)
Abstract	The alveolar-arterial oxygen gradient (DeltaA-a) provides a useful assessment of ventilation/perfusion (V/Q) abnormalities. The objectives of the present study were to: (i) examine the correlation between the DeltaA-a and the pneumonia severity index (PSI); and (ii) determine whether these measures were comparable in predicting clinical outcomes. The present study was conducted at a 750-bed teaching hospital. It examined a retrospective cohort of 255 patients with community acquired pneumonia (CAP) over a 2 year period. Association between the CAP and DeltaA-a was investigated by regression models and correlation, as well as two logistic models for subjects bifurcated by low-risk/moderate-to-high risk. The decision levels (DL) for both PSI and DeltaA-a were then compared as predictors of both length of stay (LOS) and survival. The correlation between PSI and DeltaA-a was strong (rho = 0.76; P < 0.0001) and was best modelled by a curvilinear relationship. Both logistic models indicated a strong association (P < 0.001) between DeltaA-a and PSI and yielded an optimal DL for the DeltaA-a of < 89 mmHg. Inter-test agreement of DeltaA-a with PSI was 76.9% (kappa = 0.60; 95% confidence interval 0.47-0.72; P < 0.0001). At < 89 mmHg, the odds ratios for LOS were similar to those at PSI = 90 in predicting LOS in the range 3-7 days, inclusive. There was no significant difference in the ability of DeltaA-a and PSI to predict survival for either the low- or high-risk group (P = 0.363 and P = 0.951, respectively). The DeltaA-a correlates well with PSI and performs comparably in predicting two major outcomes in subjects hospitalized with CAP.
File Format	HTM / HTML
ISSN	03051870
Issue Number	9
Volume Number	35
e-ISSN	14401681
Journal	Clinical and Experimental Pharmacology and Physiology
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2008-09-01
Publisher Place	Australia
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Physiology Discipline Pharmacology Bronchial Arteries Physiopathology Hospitalization Oxygen Consumption Physiology Pneumonia, Bacterial Diagnosis Severity Of Illness Index Adult Aged Aged, 80 And Over Cohort Studies Community-acquired Infections Pathology Female Humans Length Of Stay Male Middle Aged Prognosis Pulmonary Alveoli Blood Supply Retrospective Studies Young Adult Comparative Study Journal Article
Content Type	Text
Resource Type	Article
Subject	Physiology Physiology (medical) Pharmacology

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