PREDICTION OF MICROBIAL ETIOLOGY AT ADMISSION TO HOSPITAL FOR PNEUMONIA FROM THE PRESENTING CLINICAL-FEATURES
PREDICTION OF MICROBIAL ETIOLOGY AT ADMISSION TO HOSPITAL FOR PNEUMONIA FROM THE PRESENTING CLINICAL-FEATURES
复制标题
DOI：
10.1136/thx.44.12.1031
复制
发表时间：
1989-12-01
期刊：
影响因子：
10
通讯作者：
CONNOLLY, CK
中科院分区：
文献类型：
--
作者：
FARR, BM;KAISER, DL;CONNOLLY, CK
社区获得性肺炎患者初始抗菌治疗的选择是一个重要的临床决策。由于这一决定通常是在特定的微生物检测结果可用之前做出的，我们试图确定目前的临床特征如何能够预测441例因肺炎住院的成人的微生物病原学。入院时90个变量中有5个被纳入多元判别函数分析，因为它们与一个或多个主要病因子集（肺炎支原体、肺炎链球菌、"其他"和未确定）有很强的相关性。这些变量包括年龄、入院前患病天数、胸片上有无血痰和肺叶浸润以及白色血细胞计数。在只有42%的病例中，通过这种判别函数分析正确预测了微生物病原学，这给出了在肺炎入院时确定微生物病原学所遇到的困难程度的定量估计。当一个类似的判别函数分析应用于三分之一的病人，其中微生物病因从未确定，这些病例中的大多数被预测为由于S。肺炎。
The selection of initial antimicrobial treatment in a patient with community acquired pneumonia is an important clinical decision. Because this decision is usually made before the results of specific microbiological tests are available, we attempted to determine how well the presenting clinical features would allow prediction of microbial aetiology in 441 adults admitted to hospital with pneumonia. Five of 90 variables on admission were selected for inclusion in a multivariate discriminant function analysis because of their strong association with one or more of the major aetiological subsets (Mycoplasma pneumoniae, Streptococcus pneumoniae, "other," and undetermined). These variables were age, number of days ill before admission, presence or absence of bloody sputum and of lobar infiltration on chest radiograph, and white blood cell count. The microbial aetiology was correctly predicted by this discriminant function analysis in only 42% of cases, which gives a quantitative estimate of the degree of difficulty encountered in determining the microbial aetiology at the time of admission for pneumonia. When a similar discriminant function analysis was applied to the third of patients in whom the microbial aetiology was never determined, most of these cases were predicted to be due to S. pneumoniae.