TY - JOUR
T1 - Comparison of the Predictive Capacity of Oxygenation Parameters, Oxygenation Indices, and CURB-65 to Mortality, Mechanical Ventilation, and Vasopressor Support in Community-Acquired Pneumonia at Different Altitudes
AU - Bastidas Goyes, Alirio Rodrigo
A2 - Tuta Quintero, Eduardo Andres
A2 - Mora Barrero, Angelica Vanessa
A2 - Reyes, Luis Felipe
A2 - Bello Sarmiento, Laura Elizabeth
A2 - Nonzoque Moreno, Alejandra Paola
A2 - Saza Salas, Laura Daniela
A2 - Trujillo Angel, Natalia
A2 - Arias Arismendy, Jeniffer Camila
A2 - Mejia Martínez , Paola
A2 - Osorio Mañaca, Daniel
A2 - Narvaez Ramirez, Paula Oriana
A2 - Perdomo Rodriguez, Laura Sofia
A2 - Vargas Arcila, Luis Miguel
A2 - Perez Hernandez, Maria Alejandra
A2 - Rubiano, Jesús Fernando
A2 - Pinillos, Paula Catalina
A2 - Naranjo Piñeros, Juan Manuel
A2 - Martinez Covaleda, Angela Maria
N1 - Publisher Copyright:
Copyright © 2025 Eduardo Tuta-Quintero et al. Canadian Respiratory Journal published by John Wiley & Sons Ltd.
PY - 2025/3/11
Y1 - 2025/3/11
N2 - Background: Populations residing at high altitudes display distinct physiological adaptations that are essential for understanding respiratory diseases. However, there is limited research on how these adaptations affect the assessment and prognosis of community-acquired pneumonia (CAP). Methods: A prognostic validation nested within a retrospective cohort was conducted on subjects with pneumonia admitted to two high-complexity institutions in Colombia at different altitudes above sea level. The receiver operating characteristic (ROC) curves were calculated for SaO
2, PaO
2, SpO
2, A-a O
2 gradient, a-A index, PaO
2/FiO
2, SpO
2/FiO
2, and the CURB-65 score to predict 30-day mortality, requirement for invasive mechanical ventilation (IMV), and need for vasopressor support. Results: 3467 were selected for analysis, with 73.7% (2557/3467) residing at high altitudes and 26.2% (910/3467) at low altitudes. The CURB-65 score ≥ 2 showed a performance in predicting mortality of 0.707 (95% CI: 0.653–0.761; p < 0.001) at low altitudes and 0.737 (95% CI: 0.709–0.765; p < 0.001) at high altitudes. The PaO
2/FiO
2 ≤ 300 showed a performance in predicting the need for IMV and vasopressor support of 0.734 (95% CI: 0.685–0.783; p < 0.001) and 0.724 (0.674–0.775; p < 0.001) at high altitudes, respectively. The SpO
2/FiO
2 ≤ 350 showed a performance in predicting the need for IMV of 0.679 (0.507–0.85; p < 0.001) at low altitudes. The A-a O
2 gradient ≥ 10 showed a performance in predicting the need for vasopressor support of 0.686 (95% CI: 0.537–0.835; p = 0.06) at low altitudes. Conclusion: In patients with CAP at altitudes above 2500 m above sea level, PaO
2/FiO
2, SpO
2/FiO
2, and the A-a O
2 gradient show a greater predictive capacity for 30-day mortality, need for IMV, and vasopressor requirements. The CURB-65 score showed a good predictive performance.
AB - Background: Populations residing at high altitudes display distinct physiological adaptations that are essential for understanding respiratory diseases. However, there is limited research on how these adaptations affect the assessment and prognosis of community-acquired pneumonia (CAP). Methods: A prognostic validation nested within a retrospective cohort was conducted on subjects with pneumonia admitted to two high-complexity institutions in Colombia at different altitudes above sea level. The receiver operating characteristic (ROC) curves were calculated for SaO
2, PaO
2, SpO
2, A-a O
2 gradient, a-A index, PaO
2/FiO
2, SpO
2/FiO
2, and the CURB-65 score to predict 30-day mortality, requirement for invasive mechanical ventilation (IMV), and need for vasopressor support. Results: 3467 were selected for analysis, with 73.7% (2557/3467) residing at high altitudes and 26.2% (910/3467) at low altitudes. The CURB-65 score ≥ 2 showed a performance in predicting mortality of 0.707 (95% CI: 0.653–0.761; p < 0.001) at low altitudes and 0.737 (95% CI: 0.709–0.765; p < 0.001) at high altitudes. The PaO
2/FiO
2 ≤ 300 showed a performance in predicting the need for IMV and vasopressor support of 0.734 (95% CI: 0.685–0.783; p < 0.001) and 0.724 (0.674–0.775; p < 0.001) at high altitudes, respectively. The SpO
2/FiO
2 ≤ 350 showed a performance in predicting the need for IMV of 0.679 (0.507–0.85; p < 0.001) at low altitudes. The A-a O
2 gradient ≥ 10 showed a performance in predicting the need for vasopressor support of 0.686 (95% CI: 0.537–0.835; p = 0.06) at low altitudes. Conclusion: In patients with CAP at altitudes above 2500 m above sea level, PaO
2/FiO
2, SpO
2/FiO
2, and the A-a O
2 gradient show a greater predictive capacity for 30-day mortality, need for IMV, and vasopressor requirements. The CURB-65 score showed a good predictive performance.
UR - https://onlinelibrary.wiley.com/doi/10.1155/carj/9378618
UR - https://www.scopus.com/pages/publications/105002142969
U2 - 10.1155/carj/9378618
DO - 10.1155/carj/9378618
M3 - Artículo
SN - 1198-2241
VL - 2025
SP - 1
EP - 9
JO - Canadian Respiratory Journal
JF - Canadian Respiratory Journal
IS - 1
M1 - 9378618
ER -