Evidence map›Paper›PMID 37935890›Full record

ArticleAnnals of intensive care2023

Prediction of pulmonary aspergillosis in patients with ventilator-associated pneumonia.

Nicolas Massart, Emma Plainfosse, Yanis Benameur, Clarisse Dupin, Florence Legall, Anne Cady, Frederic Gourmelin, François Legay, Nicolas Barbarot, Eric Magalhaes and 3 more

Open access · goldAbstract read
In one paragraph

Article in Annals of intensive care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 33% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Guideline
  2. Article
  3. Article
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 at 4 institutions in 1 country.

Nicolas MassartService de Réanimation, CH de St BRIEUC, 10, Rue Marcel Proust, 22000, Saint-Brieuc, France. nicolasmassart@hotmail.fr.ORCID http://orcid.org/0000-0001-5828-0197
Emma PlainfosseService de Réanimation, CH de St BRIEUC, 10, Rue Marcel Proust, 22000, Saint-Brieuc, France.
Yanis BenameurService de Réanimation, CH de QUIMPER, 14Bis Avenue Yves Thépot, 29107, Quimper, France.
Clarisse DupinService de Microbiologie, CH de St BRIEUC, 10, rue marcel Proust, 22000, Saint-Brieuc, France.
Florence LegallService de Microbiologie, CH de QUIMPER, 14bis Avenue Yves Thépot, 29107, Quimper, France.
Anne CadyLaboratoire de Biologie Médicale, CH de Vannes, 20, bd Maurice Guillaudot, 56000, Vannes, France.
Frederic GourmelinService de Réanimation, CH de Saint-Malo, 1 rue de la marne, 35400, Saint-Malo, France.
François LegayService de Réanimation, CH de St BRIEUC, 10, Rue Marcel Proust, 22000, Saint-Brieuc, France.
Nicolas BarbarotService de Réanimation, CH de St BRIEUC, 10, Rue Marcel Proust, 22000, Saint-Brieuc, France.
Eric MagalhaesService de Réanimation, CH de St BRIEUC, 10, Rue Marcel Proust, 22000, Saint-Brieuc, France.
Pierre FillatreService de Réanimation, CH de St BRIEUC, 10, Rue Marcel Proust, 22000, Saint-Brieuc, France.
Aurélien FrerouService de Réanimation, CH de Saint-Malo, 1 rue de la marne, 35400, Saint-Malo, France.
Florian ReizineService de Réanimation, CH de Vannes, 20, bd Maurice Guillaudot, 56000, Vannes, France.
Centre Hospitalier de Saint-Brieuc · FRCentre Hospitalier de Cornouaille · FRCentre Hospitalier de Saint-Malo · FRCentre hospitalier Bretagne Atlantique · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPredictors of ICU-acquired pulmonary aspergillosis (IPA) are not well-established in critically ill patients with ventilator-associated pneumonia (VAP), making IPA commonly misdiagnosed and anti-fungal therapy delayed. We aimed to develop a clinical score for prediction of IPA among patients with VAP.

methodsMechanically ventilated patients who developed VAP in 4 ICUs in Bretagne, Western France, were included. The score was constructed in a learning cohort, based on predictors of IPA in logistic regression model, and validated in a validation cohort.

resultsAmong 1636 mechanically ventilated patients, 215 developed VAP but only 39 developed IPA (4 possible and 35 probable/putative) (18%). Most cases (31/39) were documented through a positive broncho-alveolar sample culture. Independent predictors of IPA were immunodepression (including onco-hematological disorder, immunomodulatory treatment, solid organ transplant, neutropenia < 0.5G/L and high-dose steroids ≥ 1 mg/kg/day of prednisolone equivalent) (p = 0.001; score = 1 point) and lymphocyte count at admission < 0.8 G/L (p = 0.019; score = 1 point). Operational values of the predictive score in the learning/validation cohort were 50%/52% sensitivity and 90%/87% specificity, respectively, for high PiPa score (score = 2) and 94%/91% sensitivity and 44%/46% specificity, respectively, for moderate PiPa score (score = 1). Finally, the AUC for the prediction of IPA was 0.783 in the learning cohort and 0.770 in the validation cohort.

conclusionsWe evaluated a clinical score with good predictive value which may help to predict IPA in patient with VAP. External validation will be needed to confirm our preliminary findings.

Indexed as

Acquired infectionCritical carePneumoniaPrediction scorePulmonary aspergillosis

Identifiers

PMID37935890
PMCPMC10630265
OpenAlexW4388452660

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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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.