Journal
RESPIRATORY CARE
Volume 56, Issue 8, Pages 1087-1094Publisher
DAEDALUS ENTERPRISES INC
DOI: 10.4187/respcare.01097
Keywords
ventilator-associated pneumonia; clinical pulmonary infection score; diagnosis; meta-analysis
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Funding
- Nantong science and technology commission
- Nantong University
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To assess the diagnostic accuracy of the clinical pulmonary infection score in the diagnosis of ventilator-associated pneumonia in mechanically ventilated patients. METHODS: We searched PubMed and the Cochrane database, and included only studies that compared clinical pulmonary infection score with quantitative microbiological analysis of samples for diagnosing ventilator-associated pneumonia. We constructed 2-by-2 tables of diagnostic accuracy from each article, and meta-analyzed the results by pooling estimates of sensitivity, specificity, likelihood ratio for positive index test, likelihood ratio for negative index test, diagnostic odds ratio, and 95% confidence intervals. RESULTS: Thirteen studies met the inclusion criteria. The pooled estimates for sensitivity and specificity for clinical pulmonary infection score were 65% (95% CI 61-69%) and 64% (95% CI 60-67%), respectively. The combined diagnostic odds ratio was 4.85 (95% CI 2.42-9.71) and the area under the curve was 0.748 (95% CI 0.65-0.85). CONCLUSIONS: The diagnostic performance of the clinical pulmonary infection score for ventilator-associated pneumonia is moderate. However, the clinical pulmonary infection score is simple and easy to perform, and may still be useful in diagnosing ventilator-associated pneumonia.
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