Computed tomography findings in septic patients with acute respiratory distress syndrome: correlation with survival and pulmonary versus extrapulmonary septic focus

J Comput Assist Tomogr. 2013 Jul-Aug;37(4):602-9. doi: 10.1097/RCT.0b013e318295d0c8.

Abstract

Objective: The objective of this study was to evaluate computed tomography (CT) findings in patients with sepsis with unknown inflammatory focus and acute respiratory distress syndrome.

Methods: Acute respiratory distress syndrome findings on CT of 36 patients with sepsis were graded on a 6-point scale, and the percentage of affected lung was estimated. Resulting CT scores were correlated to intensive care scores and survival.

Results: Forty-four percent of the patients died, revealing a significantly higher CT score than survivors (P = 0.01). Survivors showed larger areas of unaffected lung (P < 0.001), whereas patients with fatal outcome had more ground-glass opacities (P = 0.002; sensitivity, 73%; specificity, 57%) and traction bronchiectasis (P = 0.009; sensitivity, 54%; specificity, 68%). Pulmonary findings on CT did not allow discriminating between a pulmonary and extrapulmonary focus. No significant coherence between CT score and intensive care scores could be revealed.

Conclusions: A CT scoring system based on pulmonary findings in patients with sepsis with acute respiratory distress syndrome comprises prognostic implications in terms of the patients' survival.

MeSH terms

  • Comorbidity
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Reproducibility of Results
  • Respiratory Distress Syndrome / diagnostic imaging*
  • Respiratory Distress Syndrome / mortality*
  • Risk Factors
  • Sensitivity and Specificity
  • Sepsis / diagnostic imaging*
  • Sepsis / mortality*
  • Statistics as Topic
  • Survival Analysis
  • Survival Rate*
  • Tomography, X-Ray Computed / statistics & numerical data*