바로가기메뉴

본문 바로가기 주메뉴 바로가기

Tuberculosis & Respiratory Diseases

Article Contents

Prev Next
e-Submission

Vol.69 No.2
Citation Share

Chest CT Parameters to Predict the Major Adverse Events in Acute Submassive Pulmonary Embolism

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2010, v.69 no.2, pp.103-107










& (2010). Chest CT Parameters to Predict the Major Adverse Events in Acute Submassive Pulmonary Embolism. Tuberculosis & Respiratory Diseases, 69(2), 103-107.
  • Downloaded
  • Viewed
PDF Download

Abstract

Background: The aim of the present study was to evaluate whether findings on initial chest computed tomography (CT) of influenza pneumonia can help predict clinical outcome. Methods: We reviewed all adult patients admitted to the Emergency Department (ED) with a confirmed diagnosis of novel influenza A H1N1 virus (2009 H1N1) pneumonia, who underwent chest CT upon admission between Aug 26, 2009 and Jan 31, 2010. Radiologic findings were characterized by type and pattern of opacities and zonal distribution. Clinical outcome measures were intensive care unit (ICU) admission, mechanical ventilation, and inhospital death. Results: Of 59 patients diagnosed with 2009 H1N1 pneumonia, 41 (69.5%) underwent chest CT on admission into ED. Nine (22%) of these patients developed adverse clinical outcomes requiring the following treatments: 9 (22.0%) ICU admissions, 5 (12.2%) mechanical ventilation, and 3 (7.3%) inhospital deaths. Counting the number of patients with more than 4 involved lobes, the sensitivity, specificity, positive predictive value, and negative predictive value for detection of adverse clinical outcome were 67%, 84%, 55% and 80%, respectively. Conclusion: Extensive involvement of both lungs (over 4 lobes) is related to ICU admission, mechanical ventilation, and inhospital death. Initial chest CT may help predict an adverse clinical outcome of patients with 2009 H1N1 influenza pneumonia.

keywords
Influenza A Virus, H1N1 Subtype, Tomography, X-Ray Computed, Respiration, Artificial, Mortality, Influenza A Virus, H1N1 Subtype, Tomography, X-Ray Computed, Respiration, Artificial, Mortality

Reference

1.

1. Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, Hernandez M, Quiñones-Falconi F, Bautista E, et al.Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med 2009;361:680-9.

2.

2. Choi WJ, Kim WY, Kim SH, Oh BJ, Kim W, Lim KS,et al. Clinical characteristics of pneumonia in hospitalized patients with novel influenza A (H1N1) in Korea. Scand J Infect Dis 2010;42:311-4.

3.

3. de Roux A, Marcos MA, Garcia E, Mensa J, Ewig S,Lode H, et al. Viral community-acquired pneumonia in nonimmunocompromised adults. Chest 2004;125:1343-51.

4.

4. Jennings LC, Anderson TP, Beynon KA, Chua A, Laing RT, Werno AM, et al. Incidence and characteristics of viral community-acquired pneumonia in adults. Thorax 2008;63:42-8.

5.

5. Choi SS, Kim WY, Kim SH, Hong SB, Lim CM,Koh Y, et al. Associated factor related to major complications of patients with hospitalized for 2009 H1N1 influenza pneumonia. Tuberc Respir Dis 2010;68:162-7.

6.

6. World Health Organiztion. CDC protocol of realtime RTPCR for influenza A (H1N1) [Internet]. Geneva:World Health Organization; 2009 [updated 2009 Oct 6;cited 2010 May 20]. Available from: http://www.who.int/csr/resources/publications/swineflu/realtimeptpcr/en/index.html.

7.

7. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG,Campbell GD, Dean NC, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007;44 Suppl 2:S27-72.

8.

8. Agarwal PP, Cinti S, Kazerooni EA. Chest radiographic and CT findings in novel swine-origin influenza A (H1N1) virus (S-OIV) infection. AJR Am J Roentgenol 2009;193:1488-93.

9.

9. Bay A, Etlik O, Oner AF, Unal O, Arslan H, Bora A.Radiological and clinical course of pneumonia in patients with avian influenza H5N1. Eur J Radiol 2007;61:245-50.

Tuberculosis & Respiratory Diseases

e-Submission OA Policy