Evaluation of the IDSA/ATS Minor Criteria for Severe Community-Acquired Pneumonia

AbstractIntroduction: Our aim was to evaluate the minor criteria recommended by the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) as predictors of 30-day mortality, the need for invasive mechanical ventilation, and/or the need for vasopressor support as markers of severity in patients hospitalized with community-acquired pneumonia (CAP). Methods: Patients admitted to 2 academic teaching hospitals over a 4-year period (January 1, 1999 to December 1, 2002) were identified as having CAP. We used modified minor criteria established by the 2007 IDSA/ATS guidelines. The primary outcome measure was 30-day mortality, and the secondary outcome measures were need for invasive mechanical ventilation and/or need for vasopressor support. Results: About half of the patients in the cohort (n = 352/787 [46%]) had ≥ 1 minor criterion, but only 128 (16.3%) had ≥ 3 minor criteria present at hospital admission. In the multivariable analysis, hypoxemia, multilobar infiltrates, and leukopen...