Predictive and prognostic roles of electrical cardiometry in noninvasive assessments of community-acquired pneumonia patients with dyspnoea

• Published in: Hong Kong journal of emergency medicine Vol. 28; no. 4; pp. 205 - 214
• Main Authors: Gho, Kyungil, Woo, Seon Hee, Lee, Sang Moog, Park, Ki Cheol, Park, Gyeong Nam, Kim, Jinwoo, Hong, Sungyoup
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-07-2021; Sage Publications Ltd
• Subjects: Community-acquired pneumonia; Dyspnea; Evaluation; impedance cardiometry; Intensive care; Methodology; Mortality; Patients; Pneumonia; Prognosis; thoracic fluid content; Community-acquired pneumonia; impedance cardiometry; thoracic fluid content; prognosis
• ISSN: 1024-9079; 2309-5407
• DOI: 10.1177/1024907919860643

Background: Thoracic impedance monitoring able to detect pneumonia in the very early phase of emerging infiltration prior the patient developed remarkable clinical symptoms. However, no studies have yet been conducted on the usefulness of predicting pneumonia patient outcomes with parameters from electrical cardiometry.
Objective: In the present study, we evaluated whether parameters measured by electrical cardiometry can predict clinical outcomes including mortality and length of hospital stay in patients with community-acquired pneumonia in the emergency department.
Methods: Demographic, clinical and laboratory data were collected from enrolled patient. Electrical cardiometry monitoring was done with a portable electrical cardiometry device connected to the body surface sensor. The continuous data from electrical cardiometry were recorded, and parameters were stored on the electrical cardiometry device automatically and then the data were downloaded for further analysis.
Results: Thoracic fluid content has shown to be significantly higher in the intensive care unit admission group and in the death group. Expired patients had higher value of thoracic fluid content at emergency department admission. From a receiver operating characteristics curve analysis, thoracic fluid content presented fair AUC values of 0.72 (95% confidence interval, 0.71-0.74) and 0.73 (0.62-0.82) for prediction of 28-day mortality and intensive care unit admission. Arterial partial pressure of oxygen (PaO2), the ratio of arterial partial pressure of oxygen to inspired oxygen fraction (PaO2/FiO2 ratio) also showed excellent AUC value for prediction of mortality and intensive care unit admission.
Conclusion: Electrical cardiometry monitoring indicated new possibility to anticipate prognosis of community-acquired pneumonia patient. Increased thoracic fluid content value would relate worse outcome of the patient like mortality and intensive care unit admission. Electrical cardiometry moni