Diagnostic Accuracy of Clinical Pulmonary Infection Score for Ventilator-Associated Pneumonia: A Meta-analysis

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Abstract:

OBJECTIVE: 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.

Keywords: clinical pulmonary infection score; diagnosis; meta-analysis; ventilator-associated pneumonia

Document Type: Research Article

DOI: http://dx.doi.org/10.4187/respcare.01097

Affiliations: School of Nursing, Nantong University, Nantong City, Jiangsu Province, People’s Republic of China

Publication date: August 1, 2011

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