Prediction of pulmonary aspergillosis in patients with ventilator-associated pneumonia
Authors' conclusion
We evaluated a clinical score with good predictive value which may help to predict IPA in patient with VAP.
Study context
- Population
- Mechanically ventilated ICU patients with ventilator-associated pneumonia (VAP), 4 ICUs in Bretagne, Western FranceVAP among 1636 ventilated
- Participants
- 215 participants
- Comparison
- Learning vs Validation
- Outcome
- Prediction of ICU-acquired pulmonary aspergillosis (IPA) by a clinical score (PiPa)
Methodological detailsmulticentre, learning and validation cohorts, logistic regression
- Multicentre
- Learning and validation cohorts
- Logistic regression
Performance
As reported in the abstract
PiPa score performance for IPA
| Test or model | AUC | Sensitivity, high score (=2) | Sensitivity, moderate score (=1) | Specificity, high score (=2) | Specificity, moderate score (=1) |
|---|---|---|---|---|---|
| Learning | 0.783 | 50% | 94% | 90% | 44% |
| Validation | 0.770 | 52% | 91% | 87% | 46% |
AUC
Learning0.783
Validation0.770
Sensitivity, high score (=2)
Learning50%
Validation52%
Sensitivity, moderate score (=1)
Learning94%
Validation91%
Specificity, high score (=2)
Learning90%
Validation87%
Specificity, moderate score (=1)
Learning44%
Validation46%
- Independent predictor: immunodepression (score = 1 point)
- P = 0.001
- Independent predictor: lymphocyte count at admission < 0.8 G/L (score = 1 point)
- P = 0.019
Further findings
Incidence of IPA among patients with VAP
- IPA (4 possible, 35 probable/putative)
- 39 (18%)
- Documented by positive broncho-alveolar sample culture
- 31/39
Original publication
Prediction of pulmonary aspergillosis in patients with ventilator-associated pneumonia. Ann Intensive Care. Published 7 November 2023. doi:10.
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