Abstract
Clinical stability (CS) is the earliest outcome for patients with CAP. ATS guidelines suggested two different criteria in 2001 and 2007 to recognize patients' CS. The aim of our study was to compare the predicting ability of these two criteria. An observational, retrospective study of consecutive CAP patients admitted to the Veterans Hospital of Louisville, KY, US, between June 2001 and March 2006 was performed. Time to CS (TCS) was calculated as the number of days from hospital admission to the date the patient met CS criteria. Comparison between the two scores was performed with regard to a combined outcome including failure or death either during hospitalization or up to 30 days after discharge. A total of 487 patients (98% males; mean±SD age: 69±12 yrs) were enrolled. Mean±SD TCS of the study population was lower using ATS2001 in comparison to ATS2007 criteria (3.05±2.2 vs. 3.55±2.5 days, respectively, p<0.001). CS was identified on the same day by both scores in 38% of the population. ATS2001 criteria predicted CS earlier in comparison to ATS2007 in 40% of the population. Patients who reached clinical stability are depicted in Figure according to the two scores.
The ROC curve area based on the combined outcome was similar for both scores (0.762 for ATS2001 and 0.799 for ATS2007). ATS2001 criteria seem to predict CS earlier in comparison with ATS2007, and their use could allow to shorten the hospital stay.
- © 2011 ERS