Pneumonia outcome evaluation

Luna CM, Blanzaco D, Niederman MS, et al. Resolution of ventilator-associated pneumonia Prospective evaluation of the clinical pulmonary infection score as an early clinical predictor of outcome. Crit Care Med 2003 31 676-682. 

Barlow GD, Lamping DL, Davey PG, et al. Evaluation of outcomes in community-acquired pneumonia A guide for patients, physicians, and policymakers. Lancet Infect Dis 2003 3 476-488. 

The outcome from intraabdominal infection is not determined solely by what transpires in the abdomen. Unsatisfactory outcomes in patients with intraabdominal infections may result from complications that arise in other organ systems. A complication commonly associated with mortality after intraabdominal infection is pneumonia.26 A high APACHE (Acute Physiology And Chronic Health Evaluation) II score, a low serum albumin, and a high New York Heart Association cardiac function status were significantly and independently associated with increased mortality from intraabdominal infection.27... 

Once a chemotherapy regimen has been selected, the next step in managing chemotherapy is to define the outcome measures that will define therapeutic success and those that will define unacceptable toxicity and necessitate discontinuation of the chosen drugs. For example, resolution of fever and purulent sputum production, normalization of the white blood cell count, reversal of tachypnea and hypoxia, and improvement of constitutional signs and symptoms may be selected as measures that will be used to evaluate whether treatment of pneumonia is successful. 

The relationship between small bowel feeding compared with gastric feeding and risk ot pneumonia in critically ill patients has been evaluated. Nineteen trials with 1394 participants were included in the meta-analysis. Compared to gastric feeding, small bowel feeding was associated with a reduced risk of pneumonia (RR=0.70 95% C3 0.55-0.90) and ventilator-associated pneumonia (RR=0.68 95% Cl 0.53-0.89) [134 ]. The overall quality of the evidence for pneumonia as an outcome was rated as low. 

Rello J, Jubert P, Valles J, Artigas A, Rue M, Niederman MS. Evaluation of outcome for intubated patients with pneumonia due to Pseudomonas aeruginosa. Clin Infect Dis 1996 23 973 -978. 

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