Abstract
Background: Inappropriate antibiotic treatment for Legionella community-acquired pneumonia (L-CAP) reportedly worsens its prognosis. Therefore, accurate predictors for L-CAP are needed. Recently, two reliable prediction scores were reported by Fiumefreddo and Miyashita, and they include symptoms as a parameter. However, it is difficult to judge the patients’ symptoms because they are subjective parameters. We aimed to develop a new prediction score for L-CAP that does not include subjective parameters.
Methods: We analyzed prospective cohort data of CAP patients who were admitted to our hospital between October 2010 and November 2019. We selected the following objective parameters from the Legionella scores proposed by Fiumefreddo and Miyashita: male sex, body temperature (BT), C-reactive protein (CRP), lactate dehydrogenase (LDH), sodium (Na), and platelets (Plt), and performed univariate and multivariate analysis. The cut-off limits for each parameter were based on the two previous reports. We assigned one point to each significant parameter, and defined the total score as the Legionella score.
Results: We evaluated 50 L-CAP and 1860 non-L-CAP patients. Univariate and multivariate analyses revealed the following parameters were significant: male sex, high BT, high CRP level, high LDH level, low Na level, and low Plt level. The average score was higher in L-CAP (4 vs. 2). Receiver operating characteristics showed high diagnostic accuracy (AUC 0.853 (95%CI 0.805-0.901)), and the best cut-off was ≥3 points (sensitivity: 86% and specificity: 71%).
Conclusions: Our new Legionella prediction score has high diagnostic accuracy and can be used for predicting L-CAP in any clinical situation.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1786.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020