Evidence map›Paper›PMID 31606045›Full record

ArticleRespiratory research2019

Semi-quantitative visual assessment of chest radiography is associated with clinical outcomes in critically ill patients.

Stefanie E Mason, Paul B Dieffenbach, Joshua A Englert, Angela A Rogers, Anthony F Massaro, Laura E Fredenburgh, Angelica Higuera, Mayra Pinilla-Vera, Marta Vilas, Raul San Jose Estepar and 3 more

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Article in Respiratory research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Stefanie E MasonDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 15 Francis Street, Boston, MA, 02115, USA. smason8@bwh.harvard.edu.ORCID http://orcid.org/0000-0002-7649-9026
Paul B DieffenbachDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 15 Francis Street, Boston, MA, 02115, USA.
Joshua A EnglertDepartment of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, 2050 Kenny Road Suite 2200, Columbus, OH, 43221, USA.
Angela A RogersDepartment of Medicine, Division of Pulmonary, Critical Care Medicine, Stanford University School of Medicine, 300 Pasteur Dr A165, Stanford, CA, 94305, USA.
Anthony F MassaroDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 15 Francis Street, Boston, MA, 02115, USA.
Laura E FredenburghDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 15 Francis Street, Boston, MA, 02115, USA.
Angelica HigueraDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 15 Francis Street, Boston, MA, 02115, USA.
Mayra Pinilla-VeraDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 15 Francis Street, Boston, MA, 02115, USA.
Marta VilasApplied Chest Imaging Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston St Room 216, Boston, MA, 02215, USA.
Raul San Jose EsteparApplied Chest Imaging Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston St Room 216, Boston, MA, 02215, USA.
George R WashkoDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 15 Francis Street, Boston, MA, 02115, USA.
Rebecca M BaronDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 15 Francis Street, Boston, MA, 02115, USA.
Samuel Y AshDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 15 Francis Street, Boston, MA, 02115, USA.

Funding

RESPIRATORY RESEARCHT32HL007633 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI George R Washko · 1985 to 2026
$14.9M
Therapeutic modulation of zinc for lung injury and mechanobiologyR01HL142093 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI BARON, REBECCA M, TSCHUMPERLIN, DANIEL J. · 2019 to 2022
$2.8M
The Inflammasome: A Novel Biomarker in ALI/ARDSR01HL112747 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI BARON, REBECCA M · 2012 to 2015
$1.8M
Role of mTORC1 in ventilator induced lung injuryK08GM102695 · NIGMS · OHIO STATE UNIVERSITY · PI ENGLERT, JOSHUA A · 2013 to 2017
$998k
Characterization of Early Response to Chronic Lung Injury using Chest CTK08HL145118 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI ASH, SAMUEL · 2019 to 2022
$681k
YAP/TAZ-mediated Mechanotransduction in Pulmonary Hypertension PathogenesisK08HL143197 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI DIEFFENBACH, PAUL BRIAN · 2018 to 2021
$679k
Biomarkers of Interstitial Lung Abnormalities Predict Poor Outcomes in ARDS.R21HL145246 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI BARON, REBECCA M · 2019 to 2020
$343k
NHLBI NIH HHS K08 GM1026965NHLBI NIH HHS K08 HL143197NHLBI NIH HHS K08 HL145118NHLBI NIH HHS L30 HL134158NHLBI NIH HHS R01 HL112747NHLBI NIH HHS R01 HL112747-01NHLBI NIH HHS R01 HL142093NHLBI NIH HHS R21 HL145246NHLBI NIH HHS T32 HL007633NIGMS NIH HHS K08 GM102695
6 · The paper itself

Abstract

backgroundRespiratory pathology is a major driver of mortality in the intensive care unit (ICU), even in the absence of a primary respiratory diagnosis. Prior work has demonstrated that a visual scoring system applied to chest radiographs (CXR) is associated with adverse outcomes in ICU patients with Acute Respiratory Distress Syndrome (ARDS). We hypothesized that a simple, semi-quantitative CXR score would be associated with clinical outcomes for the general ICU population, regardless of underlying diagnosis.

methodsAll individuals enrolled in the Registry of Critical Illness at Brigham and Women's Hospital between June 2008 and August 2018 who had a CXR within 24 h of admission were included. Each patient's CXR was assigned an opacification score of 0-4 in each of four quadrants with the total score being the sum of all four quadrants. Multivariable negative binomial, logistic, and Cox regression, adjusted for age, sex, race, immunosuppression, a history of chronic obstructive pulmonary disease, a history of congestive heart failure, and APACHE II scores, were used to assess the total score's association with ICU length of stay (LOS), duration of mechanical ventilation, in-hospital mortality, 60-day mortality, and overall mortality, respectively.

resultsA total of 560 patients were included. Higher CXR scores were associated with increased mortality; for every one-point increase in score, in-hospital mortality increased 10% (OR 1.10, CI 1.05-1.16, p < 0.001) and 60-day mortality increased by 12% (OR 1.12, CI 1.07-1.17, p < 0.001). CXR scores were also independently associated with both ICU length of stay (rate ratio 1.06, CI 1.04-1.07, p < 0.001) and duration of mechanical ventilation (rate ratio 1.05, CI 1.02-1.07, p < 0.001).

conclusionsHigher values on a simple visual score of a patient's CXR on admission to the medical ICU are associated with increased in-hospital mortality, 60-day mortality, overall mortality, length of ICU stay, and duration of mechanical ventilation.

Indexed as

Critical IllnessAdultAgedAPACHEBiomarkersFemaleHospital MortalityHumansLength of StayLungMaleMiddle AgedOrgan SizeRespiration, ArtificialRespiratory Distress SyndromeRetrospective StudiesBiomarkersCritical illnessHospital mortalityIntensive care unitsRadiographySeverity of illness index

Identifiers

PMID31606045
PMCPMC6790038

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.