LAURENS MB, STEPHENS JL, HASH RB; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 703 (abstract no. 2244).
Mercer Univ. Sch. of Med., Macon, GA.
CONTEXT: It is widely held that pre-admission volume status affects the evolution of the chest radiograph in community-acquired pneumonia, but few data in this area are available. OBJECTIVE: To test the null hypothesis that hydration does not affect radiographic changes in community-acquired pneumonia. DESIGN: Retrospective chart review. SETTING: Community based teaching hospital. PATIENTS: 126 patients met inclusion criteria from a medical records database of 376 consecutive patients admitted for pneumonia. MEASUREMENTS: Patients were evaluated by age, gender, admission serum sodium, BUN, creatinine and fluid administered in the lst 48hrs of treatment. Patients were classified as either showing radiographic progression (P) or no radiographic progression (NP) based on comparison of admission and follow-up radiographs.RESULTS: By t-test, a statistically significant difference between the group of P and NP was noted for BUN (p=0.02), volume of fluid administered during the lst 48 hrs (p=0.04) and marginally for age (p=0.05). The group of patients with worsening chest x-ray (P) had higher BUN levels (mean of 34 vs. 24), more 48hr fluid intake, (mean 5824 ml vs. 4764 ml) and older age (66 yr. vs. 59 yr.) than the group whose chest x-rays did not show progression (NP). Utilizing a logistic regression model, fluid administered during the lst 48hrs was dropped because this variable was closely correlated with admission BUN levels. The same model poorly predicted those who showed worsening infiltrate on the 2nd x-ray.CONCLUSION: Elevated admission BUN and higher volume of fluid administered in the lst 48hrs of admission were associated with worsening radiographic findings of pneumonia. A prospective study is warranted to confirm these findings.
Publication Types:
Keywords:
- Humans
- Logistic Models
- Pneumonia
- Prospective Studies
- Radiography, Thoracic
- diagnosis
- radiography
Other ID:
UI: 102246308
From Meeting Abstracts