Viale P, Scudeller L, Petrosillo N, Girardi E, Cadeo B, Signorini L, Pagani L, Carosi G
Clinic of Infectious Disease, Department of Clinical and Morphological Research, School of Medicine, University of Udine, Udine, Italy.
Clin Infect Dis. 2004 Jan 15;38(2):271-9. doi: 10.1086/380788. Epub 2003 Dec 19.
Clinical stability (CS), defined as normalization of vital signs, is often used to manage inpatients with community-acquired pneumonia (CAP). The main objective of our study was to identify a reliable definition of CS for human immunodeficiency virus (HIV)-positive patients with CAP. During an 18-month period, 437 HIV-positive Italian inpatients with CAP were enrolled in the study. We used 3 definitions of CS (from a less conservative [definition 1] to a more conservative [definition 3] definition) based on combinations of different thresholds for vital signs. Assessments were performed at admission and daily during the hospital stay. For the 3 definitions, 14.9%, 8.0%, and 4.8% of patients were stable at baseline, with deterioration after reaching CS in 7.16%, 4.76%, and 2.05%, respectively. The 8 patients whose conditions deteriorated after reaching CS definition 3 (systolic blood pressure, >90 mm Hg; pulse, <90 beats/min; respiratory rate, <20 breaths/min; oxygen saturation, >90%; temperature, <37 degrees C; ability to eat; and normal mental status) survived and were discharged from the hospital. The more conservative definition of CS appears to be reliable for the management of HIV-infected patients with CAP.
临床稳定性（CS）被定义为生命体征正常化，常用于管理社区获得性肺炎（CAP）住院患者。我们研究的主要目的是为人类免疫缺陷病毒（HIV）阳性的CAP患者确定一个可靠的CS定义。在18个月期间，437名HIV阳性的意大利CAP住院患者被纳入研究。我们基于不同生命体征阈值的组合使用了3种CS定义（从较不保守的[定义1]到较保守的[定义3]）。在入院时和住院期间每天进行评估。对于这3种定义，分别有14.9%、8.0%和4.8%的患者在基线时处于稳定状态，达到CS后病情恶化的比例分别为7.16%、4.76%和2.05%。达到CS定义3（收缩压>90 mmHg；脉搏<90次/分钟；呼吸频率<20次/分钟；血氧饱和度>90%；体温<37摄氏度；进食能力；以及精神状态正常）后病情恶化的8名患者存活并出院。CS的更保守定义似乎对管理HIV感染的CAP患者是可靠的。
