Wilhelm K, Ewig S, Textor J, Krollmann G, Lüderitz B, Schild H
Radiologische Universitätsklinik Bonn.
Rofo. 1999 Feb;170(2):145-9. doi: 10.1055/s-2007-1011026.
To evaluate the independent prognostic impact of the chest radiograph for mortality from community-acquired pneumonia requiring hospitalization.
Chest radiographs of 67 patients with hospital-treated community-acquired pneumonia were analyzed with regard to the prognostic implications of radiographic patterns, extent and density of infiltrates, and its evolution during treatment.
Non-survivors had a significantly higher extent of infiltrates (p = 0.008), density of infiltrates (p = 0.05), and radiographic spread during follow-up within 48-75 hours (p = 0.0001). In multivariate analysis, persistent or progressive infiltrates were associated with a 47-fold increase, and persistent or progressive density of infiltrates with an 18-fold increase in risk of mortality. The presence of both parameters could correctly predict 96% of survivors and 90% of non-survivors.
The chest radiograph is an independent predictor of the severity of pneumonia. Both persistent or progressive infiltrates and persistent or progressive density of infiltrates are independently associated with mortality from community-acquired pneumonia.
评估胸部X光片对因社区获得性肺炎需住院治疗患者死亡率的独立预后影响。
分析了67例接受住院治疗的社区获得性肺炎患者的胸部X光片，观察其影像学表现模式、浸润范围和密度以及治疗期间的变化对预后的影响。
死亡患者的浸润范围（p = 0.008）、浸润密度（p = 0.05）以及48 - 75小时随访期间的影像学扩散程度（p = 0.0001）显著更高。多因素分析显示，持续性或进行性浸润使死亡风险增加47倍，持续性或进行性浸润密度使死亡风险增加18倍。这两个参数的存在能够正确预测96%的存活者和90%的死亡者。
胸部X光片是肺炎严重程度的独立预测指标。持续性或进行性浸润以及持续性或进行性浸润密度均与社区获得性肺炎的死亡率独立相关。
