PMID- 29247912
OWN - NLM
STAT- MEDLINE
DCOM- 20190401
LR  - 20190401
IS  - 1557-8615 (Electronic)
IS  - 0883-9441 (Linking)
VI  - 44
DP  - 2018 Apr
TI  - A small pericardial effusion is a marker of complicated hospitalization in 
      patients with community-acquired pneumonia.
PG  - 294-299
LID - S0883-9441(17)31607-6 [pii]
LID - 10.1016/j.jcrc.2017.11.030 [doi]
AB  - OBJECTIVE: Although often asymptomatic, presence of small pericardial effusion 
      (SPE) is shown to be associated with adverse events and increased mortality in 
      various conditions. This study aimed to evaluate the frequency and prognostic 
      importance of SPE in a cohort of patients hospitalized for community-acquired 
      pneumonia (CAP). METHODS: We prospectively followed 154 consecutive adult 
      patients hospitalized with CAP. The severity of CAP was evaluated with the 
      pneumonia severity index (PSI) and the CURB-65 (confusion, urea, respiratory 
      rate, arterial blood pressure and age) score. All patients underwent 
      transthoracic echocardiography within the first 48h of admission. Patients were 
      followed-up until hospital discharge or death. The outcomes of interest were 
      length of stay in hospital and complicated hospitalization (CH) which is defined 
      as intensive care unit admission, need for mechanical ventilation or in-hospital 
      mortality. This study was registered with ClinicalTrials.gov, number NCT02441855. 
      RESULTS: A total 34 episodes of CHs occurred in 21 (13.6%) patients. Older 
      patients and those with more co-morbid conditions such as diabetes, coronary 
      artery diseases, cerebrovascular diseases, and chronic obstructive pulmonary 
      diseases tended to have a higher rate of CH. Patients with CH had higher 
      N-terminal pro-brain natriuretic peptide, troponin and creatinine levels on 
      admission compared to patients without CH. Patients with CH had also higher 
      CURB-65 and PSI scores and had longer durations of stay compared to patients with 
      uncomplicated course. SPE was noted in 24 (15.6%) of the patients in our study 
      cohort. Incidence of CH was greater for patients with a SPE (26 CHs occurred in 
      14 of the 24 patients) compared to those without an effusion (8 CHs occurred in 7 
      of the 130 patients, p<0.001). Logistic multivariate analysis revealed that the 
      presence of SPE was an independent predictor of CH (OR: 3.26; 95% CI: 2.19-8.71; 
      p=0.008). CONCLUSION: This study is the first to demonstrate that the presence of 
      SPE is associated with increased adverse events in patients with CAP.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Biteker, Funda Sungur
AU  - Biteker FS
AD  - Yatagan State Hospital, Department of Infectious Diseases and Clinical 
      Microbiology, Turkey.
FAU - Biteker, Murat
AU  - Biteker M
AD  - Mugla Sitki Kocman University, Faculty of Medicine, Department of Cardiology, 
      Turkey.
FAU - Basaran, Ozcan
AU  - Basaran O
AD  - Mugla Sitki Kocman University, Faculty of Medicine, Department of Cardiology, 
      Turkey.
FAU - Dogan, Volkan
AU  - Dogan V
AD  - Mugla Sitki Kocman University, Faculty of Medicine, Department of Cardiology, 
      Turkey.
FAU - Ozlek, Bulent
AU  - Ozlek B
AD  - Mugla Sitki Kocman University, Faculty of Medicine, Department of Cardiology, 
      Turkey. Electronic address: bulent_ozlek@hotmail.com.
FAU - Yildirim, Birdal
AU  - Yildirim B
AD  - Mugla Sitki Kocman University, Faculty of Medicine, Department of Emergency 
      Medicine, Turkey.
FAU - Ozlek, Eda
AU  - Ozlek E
AD  - Mugla Sitki Kocman University, Faculty of Medicine, Department of Cardiology, 
      Turkey.
FAU - Celik, Oguzhan
AU  - Celik O
AD  - Mugla Sitki Kocman University, Faculty of Medicine, Department of Cardiology, 
      Turkey.
LA  - eng
SI  - ClinicalTrials.gov/NCT02441855
PT  - Journal Article
PT  - Observational Study
DEP - 20171123
PL  - United States
TA  - J Crit Care
JT  - Journal of critical care
JID - 8610642
SB  - IM
CIN - J Crit Care. 2018 Oct;47:345. PMID: 29735269
CIN - J Crit Care. 2018 Oct;47:344. PMID: 29859646
MH  - Aged
MH  - Community-Acquired Infections/*complications/mortality/physiopathology
MH  - Echocardiography
MH  - Female
MH  - Hospital Mortality
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pericardial Effusion/*diagnostic imaging/etiology/mortality
MH  - Pneumonia/*complications/mortality/physiopathology
MH  - Prognosis
MH  - Prospective Studies
MH  - Severity of Illness Index
OTO - NOTNLM
OT  - Community acquired pneumonia
OT  - Echocardiography
OT  - small pericardial effusion
EDAT- 2017/12/17 06:00
MHDA- 2019/04/02 06:00
CRDT- 2017/12/17 06:00
PHST- 2017/10/10 00:00 [received]
PHST- 2017/11/20 00:00 [revised]
PHST- 2017/11/21 00:00 [accepted]
PHST- 2017/12/17 06:00 [pubmed]
PHST- 2019/04/02 06:00 [medline]
PHST- 2017/12/17 06:00 [entrez]
AID - S0883-9441(17)31607-6 [pii]
AID - 10.1016/j.jcrc.2017.11.030 [doi]
PST - ppublish
SO  - J Crit Care. 2018 Apr;44:294-299. doi: 10.1016/j.jcrc.2017.11.030. Epub 2017 Nov 
      23.