Pleural Effusions at First ED Encounter Predict Worse Clinical Outcomes in Patients With Pneumonia

Chest
Nathan C DeanY C Gary Lee

Abstract

Pleural effusions are present in 15% to 44% of hospitalized patients with pneumonia. It is unknown whether effusions at first presentation to the ED influence outcomes or should be managed differently. We studied patients in seven hospital EDs with International Statistical Classification of Disease and Health Related Problems-Version 9 codes for pneumonia, or empyema, sepsis, or respiratory failure with secondary pneumonia. Patients with no confirmatory findings on chest imaging were excluded. Pleural effusions were identified with the use of radiographic imaging. Over 24 months, 4,771 of 458,837 adult ED patients fulfilled entry criteria. Among the 690 (14.5%) patients with pleural effusions, their median age was 68 years, and 46% were male. Patients with higher Elixhauser comorbidity scores (OR, 1.13 [95% CI, 1.09-1.18]; P < .001), brain natriuretic peptide levels (OR, 1.20 [95% CI, 1.12-1.28]; P < .001), bilirubin levels (OR, 1.07 [95% CI, 1.00-1.15]; P = .04), and age (OR, 1.15 [95% CI, 1.09-1.21]; P < .001) were more likely to have parapneumonic effusions. In patients without effusion, electronic version of CURB-65 (confusion, uremia, respiratory rate, BP, age ≥ 65 years accurately predicted mortality (4.7% predicted vs 5...Continue Reading

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References

Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Sep 16, 1998·Clinical Therapeutics·M S NiedermanR Popovian
Sep 27, 2006·The American Journal of Medicine·Rabia A AhmedJane Q Huang
Feb 6, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Lionel A MandellUNKNOWN American Thoracic Society
Feb 3, 2009·Trends in Ecology & Evolution·Benjamin M BolkerJada-Simone S White
Dec 24, 2009·Thorax·V SkourasR W Light
May 14, 2011·The European Respiratory Journal·M FalgueraJ M Porcel
May 29, 2014·Clinical Orthopaedics and Related Research·Mariano E MenendezDavid Ring
Sep 24, 2014·BMC Pulmonary Medicine·Barbara E JonesNathan C Dean
May 23, 2015·Respirology : Official Journal of the Asian Pacific Society of Respirology·Francisco SanzJosé Blanquer
Jul 15, 2015·The New England Journal of Medicine·Seema JainUNKNOWN CDC EPIC Study Team

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Citations

Nov 7, 2016·Langenbeck's Archives of Surgery·Martin ReichertAndreas Hecker
May 26, 2017·Respirology : Official Journal of the Asian Pacific Society of Respirology·Deirdre B Fitzgerald, Y C Gary Lee
Sep 1, 2017·AJR. American Journal of Roentgenology·Jeffrey Forris Beecham ChickDavid M Williams
May 22, 2018·Expert Review of Respiratory Medicine·Lucía FerreiroLuis Valdés
Mar 15, 2018·Current Opinion in Pulmonary Medicine·Ka Pang ChanY C Gary Lee
Dec 12, 2018·Respirology : Official Journal of the Asian Pacific Society of Respirology·Pyng Lee
Feb 2, 2019·Expert Review of Respiratory Medicine·Eihab O BedawiNajib M Rahman
Jun 12, 2018·Case Reports in Pediatrics·George Vasquez-RiosWilder Alarcon
Apr 6, 2019·BioMed Research International·Chih-Min SuCheng-Hsien Lu
Oct 24, 2019·Expert Review of Respiratory Medicine·Lucía FerreiroLuis Valdés
Nov 28, 2020·The European Respiratory Journal·José M Porcel
Dec 23, 2020·Annals of Emergency Medicine·UNKNOWN American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Community-Acquired PneumoniaStephen J Wolf
Mar 3, 2021·European Respiratory Review : an Official Journal of the European Respiratory Society·Eihab O BedawiPhilippe Astoul
Mar 3, 2021·International Journal of Clinical Practice·Xiao-Shan WeiQiong Zhou
May 27, 2021·Journal of Medical Microbiology·Temi LampejoJonathan Lambourne

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