Loading…
Diagnostic performance of congestion score index evaluated from chest radiography for acute heart failure in the emergency department: A retrospective analysis from the PARADISE cohort
Congestion score index (CSI), a semiquantitative evaluation of congestion on chest radiography (CXR), is associated with outcome in patients with heart failure (HF). However, its diagnostic value in patients admitted for acute dyspnea has yet to be evaluated. The diagnostic value of CSI for acute HF...
Saved in:
| Published in: | PLoS medicine 2020-11, Vol.17 (11), p.e1003419-e1003419 |
|---|---|
| Main Authors: | , , , , , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c798t-63dd82caf6a895626d1c44fb83dd3ff6d21343af193f2cbfe31b355374b709223 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c798t-63dd82caf6a895626d1c44fb83dd3ff6d21343af193f2cbfe31b355374b709223 |
| container_end_page | e1003419 |
| container_issue | 11 |
| container_start_page | e1003419 |
| container_title | PLoS medicine |
| container_volume | 17 |
| creator | Kobayashi, Masatake Douair, Amine Duarte, Kevin Jaeger, Déborah Giacomin, Gaetan Bassand, Adrien Jeangeorges, Victor Abensur Vuillaume, Laure Preud'homme, Gregoire Huttin, Olivier Zannad, Faiez Rossignol, Patrick Chouihed, Tahar Girerd, Nicolas |
| description | Congestion score index (CSI), a semiquantitative evaluation of congestion on chest radiography (CXR), is associated with outcome in patients with heart failure (HF). However, its diagnostic value in patients admitted for acute dyspnea has yet to be evaluated.
The diagnostic value of CSI for acute HF (AHF; adjudicated from patients' discharge files) was studied in the Pathway of dyspneic patients in Emergency (PARADISE) cohort, including patients aged 18 years or older admitted for acute dyspnea in the emergency department (ED) of the Nancy University Hospital (France) between January 1, 2015 and December 31, 2015. CSI (ranging from 0 to 3) was evaluated using a semiquantitative method on CXR in consecutive patients admitted for acute dyspnea in the ED. Results were validated in independent cohorts (N = 224). Of 1,333 patients, mean (standard deviation [SD]) age was 72.0 (18.5) years, 686 (51.5%) were men, and mean (SD) CSI was 1.42 (0.79). Patients with higher CSI had more cardiovascular comorbidities, more severe congestion, higher b-type natriuretic peptide (BNP), poorer renal function, and more respiratory acidosis. AHF was diagnosed in 289 (21.7%) patients. CSI was significantly associated with AHF diagnosis (adjusted odds ratio [OR] for 0.1 unit CSI increase 1.19, 95% CI 1.16-1.22, p < 0.001) after adjustment for clinical-based diagnostic score including age, comorbidity burden, dyspnea, and clinical congestion. The diagnostic accuracy of CSI for AHF was >0.80, whether alone (area under the receiver operating characteristic curve [AUROC] 0.84, 95% CI 0.82-0.86) or in addition to the clinical model (AUROC 0.87, 95% CI 0.85-0.90). CSI improved diagnostic accuracy on top of clinical variables (net reclassification improvement [NRI] = 94.9%) and clinical variables plus BNP (NRI = 55.0%). Similar diagnostic accuracy was observed in the validation cohorts (AUROC 0.75, 95% CI 0.68-0.82). The key limitation of our derivation cohort was its single-center and retrospective nature, which was counterbalanced by the validation in the independent cohorts.
In this study, we observed that a systematic semiquantified assessment of radiographic pulmonary congestion showed high diagnostic value for AHF in dyspneic patients. Better use of CXR may provide an inexpensive, widely, and readily available method for AHF triage in the ED. |
| doi_str_mv | 10.1371/journal.pmed.1003419 |
| format | article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2696083864</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A650814982</galeid><doaj_id>oai_doaj_org_article_e872fc392a8c4a08bba3cb1b49821904</doaj_id><sourcerecordid>A650814982</sourcerecordid><originalsourceid>FETCH-LOGICAL-c798t-63dd82caf6a895626d1c44fb83dd3ff6d21343af193f2cbfe31b355374b709223</originalsourceid><addsrcrecordid>eNqVk89u1DAQxiMEoqXwBggsISF62MWO85cD0qotdKUVRS1wtRxnnLhK4sVOVt034_GYdLdVt9oDKAdH49_3jWfsCYLXjE4ZT9nHazu4TjbTZQvllFHKI5Y_CQ5ZHOUTlqTJ0wf_B8EL768pDXOa0-fBAecsjTMeHgZ_To2sOut7o8gSnLaulZ0CYjVRtqsAN2xHvLIOiOlKuCGwks0geyiJdrYlqkaGOFkaWzm5rNcEPYhUQw-kBul6oqVphls56Wsg0IKroFNrUsIS91vo-k9kRhz0zvolqN6sgEgsbe2N3yQZdd9nl7PT-dUZnqu2rn8ZPNOy8fBqux4FP7-c_Tg5nywuvs5PZouJSvOsnyS8LLNQSZ3ILI-TMCmZiiJdZBjnWidlyHjEpWY516EqNHBW8DjmaVSkNA9DfhS83fguG-vFtulehEme0IxnSYTEfEOUVl6LpTOtdGthpRG3AesqgWUa1YCALA214nkoMxVJmhWF5KpgRZRnIcvp6PV5m20o8F4V9sbJZsd0d6cztajsSqRJnMaMosHxxqB-JDufLcQYo5wiliYrhuyHbTJnfw94jaI1XkHTyA7sgDVGCaVZzMIY0XeP0P2d2FKVxGJNpy2eUY2mYpbENGNjnUhN9lD4JAALsh1og-EdfrqHx6-E1qi9guMdATI93PSVHLwX86vL_2C__Tt78WuXff-AxUFo-trbZhjHye-C0QZU-Pq9A31_a4yKcdDvOi3GQRfbQUfZm4cP5V50N9n8L8yvTtY</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2696083864</pqid></control><display><type>article</type><title>Diagnostic performance of congestion score index evaluated from chest radiography for acute heart failure in the emergency department: A retrospective analysis from the PARADISE cohort</title><source>Open Access: PubMed Central</source><source>Publicly Available Content Database</source><creator>Kobayashi, Masatake ; Douair, Amine ; Duarte, Kevin ; Jaeger, Déborah ; Giacomin, Gaetan ; Bassand, Adrien ; Jeangeorges, Victor ; Abensur Vuillaume, Laure ; Preud'homme, Gregoire ; Huttin, Olivier ; Zannad, Faiez ; Rossignol, Patrick ; Chouihed, Tahar ; Girerd, Nicolas</creator><contributor>Oguri, Mitsutoshi</contributor><creatorcontrib>Kobayashi, Masatake ; Douair, Amine ; Duarte, Kevin ; Jaeger, Déborah ; Giacomin, Gaetan ; Bassand, Adrien ; Jeangeorges, Victor ; Abensur Vuillaume, Laure ; Preud'homme, Gregoire ; Huttin, Olivier ; Zannad, Faiez ; Rossignol, Patrick ; Chouihed, Tahar ; Girerd, Nicolas ; Oguri, Mitsutoshi</creatorcontrib><description>Congestion score index (CSI), a semiquantitative evaluation of congestion on chest radiography (CXR), is associated with outcome in patients with heart failure (HF). However, its diagnostic value in patients admitted for acute dyspnea has yet to be evaluated.
The diagnostic value of CSI for acute HF (AHF; adjudicated from patients' discharge files) was studied in the Pathway of dyspneic patients in Emergency (PARADISE) cohort, including patients aged 18 years or older admitted for acute dyspnea in the emergency department (ED) of the Nancy University Hospital (France) between January 1, 2015 and December 31, 2015. CSI (ranging from 0 to 3) was evaluated using a semiquantitative method on CXR in consecutive patients admitted for acute dyspnea in the ED. Results were validated in independent cohorts (N = 224). Of 1,333 patients, mean (standard deviation [SD]) age was 72.0 (18.5) years, 686 (51.5%) were men, and mean (SD) CSI was 1.42 (0.79). Patients with higher CSI had more cardiovascular comorbidities, more severe congestion, higher b-type natriuretic peptide (BNP), poorer renal function, and more respiratory acidosis. AHF was diagnosed in 289 (21.7%) patients. CSI was significantly associated with AHF diagnosis (adjusted odds ratio [OR] for 0.1 unit CSI increase 1.19, 95% CI 1.16-1.22, p < 0.001) after adjustment for clinical-based diagnostic score including age, comorbidity burden, dyspnea, and clinical congestion. The diagnostic accuracy of CSI for AHF was >0.80, whether alone (area under the receiver operating characteristic curve [AUROC] 0.84, 95% CI 0.82-0.86) or in addition to the clinical model (AUROC 0.87, 95% CI 0.85-0.90). CSI improved diagnostic accuracy on top of clinical variables (net reclassification improvement [NRI] = 94.9%) and clinical variables plus BNP (NRI = 55.0%). Similar diagnostic accuracy was observed in the validation cohorts (AUROC 0.75, 95% CI 0.68-0.82). The key limitation of our derivation cohort was its single-center and retrospective nature, which was counterbalanced by the validation in the independent cohorts.
In this study, we observed that a systematic semiquantified assessment of radiographic pulmonary congestion showed high diagnostic value for AHF in dyspneic patients. Better use of CXR may provide an inexpensive, widely, and readily available method for AHF triage in the ED.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1003419</identifier><identifier>PMID: 33175832</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acidosis ; Acute Disease ; Adolescent ; Aged ; Biology and Life Sciences ; Brain natriuretic peptide ; Cardiology ; Cardiology and cardiovascular system ; Care and treatment ; Chest ; Chronic obstructive pulmonary disease ; Cohort Studies ; Comorbid patients ; Comorbidity ; Complications and side effects ; Congestive heart failure ; Demographic aspects ; Diagnosis ; Disease management ; Dyspnea ; Dyspnea - complications ; Dyspnea - diagnosis ; Edema ; Emergencies ; Emergency medical care ; Emergency service ; Emergency Service, Hospital ; Female ; France ; Health care access ; Heart failure ; Heart Failure - diagnosis ; Heart Failure - epidemiology ; Hospitalization - statistics & numerical data ; Hospitals ; Human health and pathology ; Humans ; Life Sciences ; Male ; Medical examination ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Patient outcomes ; Patients ; Peptides ; Pleural effusion ; Pneumonia ; Pulmonary edema ; Radiography ; Radiography - statistics & numerical data ; Reclassification ; Renal function ; Reproducibility ; Respiration ; Retrospective Studies ; Risk factors ; ROC Curve ; Shortness of breath ; Statistics</subject><ispartof>PLoS medicine, 2020-11, Vol.17 (11), p.e1003419-e1003419</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Kobayashi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><rights>2020 Kobayashi et al 2020 Kobayashi et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c798t-63dd82caf6a895626d1c44fb83dd3ff6d21343af193f2cbfe31b355374b709223</citedby><cites>FETCH-LOGICAL-c798t-63dd82caf6a895626d1c44fb83dd3ff6d21343af193f2cbfe31b355374b709223</cites><orcidid>0000-0002-3631-9633 ; 0000-0003-2527-8458 ; 0000-0003-1531-7409 ; 0000-0002-3278-2057 ; 0000-0002-0292-0498 ; 0000-0001-8708-1402 ; 0000-0001-8009-3873 ; 0000-0003-0008-2256 ; 0000-0002-3583-7172 ; 0000-0001-7456-1570</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2696083864/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2696083864?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,315,733,786,790,891,25783,27957,27958,37047,37048,44625,53827,53829,75483</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33175832$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.univ-lorraine.fr/hal-03010376$$DView record in HAL$$Hfree_for_read</backlink></links><search><contributor>Oguri, Mitsutoshi</contributor><creatorcontrib>Kobayashi, Masatake</creatorcontrib><creatorcontrib>Douair, Amine</creatorcontrib><creatorcontrib>Duarte, Kevin</creatorcontrib><creatorcontrib>Jaeger, Déborah</creatorcontrib><creatorcontrib>Giacomin, Gaetan</creatorcontrib><creatorcontrib>Bassand, Adrien</creatorcontrib><creatorcontrib>Jeangeorges, Victor</creatorcontrib><creatorcontrib>Abensur Vuillaume, Laure</creatorcontrib><creatorcontrib>Preud'homme, Gregoire</creatorcontrib><creatorcontrib>Huttin, Olivier</creatorcontrib><creatorcontrib>Zannad, Faiez</creatorcontrib><creatorcontrib>Rossignol, Patrick</creatorcontrib><creatorcontrib>Chouihed, Tahar</creatorcontrib><creatorcontrib>Girerd, Nicolas</creatorcontrib><title>Diagnostic performance of congestion score index evaluated from chest radiography for acute heart failure in the emergency department: A retrospective analysis from the PARADISE cohort</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>Congestion score index (CSI), a semiquantitative evaluation of congestion on chest radiography (CXR), is associated with outcome in patients with heart failure (HF). However, its diagnostic value in patients admitted for acute dyspnea has yet to be evaluated.
The diagnostic value of CSI for acute HF (AHF; adjudicated from patients' discharge files) was studied in the Pathway of dyspneic patients in Emergency (PARADISE) cohort, including patients aged 18 years or older admitted for acute dyspnea in the emergency department (ED) of the Nancy University Hospital (France) between January 1, 2015 and December 31, 2015. CSI (ranging from 0 to 3) was evaluated using a semiquantitative method on CXR in consecutive patients admitted for acute dyspnea in the ED. Results were validated in independent cohorts (N = 224). Of 1,333 patients, mean (standard deviation [SD]) age was 72.0 (18.5) years, 686 (51.5%) were men, and mean (SD) CSI was 1.42 (0.79). Patients with higher CSI had more cardiovascular comorbidities, more severe congestion, higher b-type natriuretic peptide (BNP), poorer renal function, and more respiratory acidosis. AHF was diagnosed in 289 (21.7%) patients. CSI was significantly associated with AHF diagnosis (adjusted odds ratio [OR] for 0.1 unit CSI increase 1.19, 95% CI 1.16-1.22, p < 0.001) after adjustment for clinical-based diagnostic score including age, comorbidity burden, dyspnea, and clinical congestion. The diagnostic accuracy of CSI for AHF was >0.80, whether alone (area under the receiver operating characteristic curve [AUROC] 0.84, 95% CI 0.82-0.86) or in addition to the clinical model (AUROC 0.87, 95% CI 0.85-0.90). CSI improved diagnostic accuracy on top of clinical variables (net reclassification improvement [NRI] = 94.9%) and clinical variables plus BNP (NRI = 55.0%). Similar diagnostic accuracy was observed in the validation cohorts (AUROC 0.75, 95% CI 0.68-0.82). The key limitation of our derivation cohort was its single-center and retrospective nature, which was counterbalanced by the validation in the independent cohorts.
In this study, we observed that a systematic semiquantified assessment of radiographic pulmonary congestion showed high diagnostic value for AHF in dyspneic patients. Better use of CXR may provide an inexpensive, widely, and readily available method for AHF triage in the ED.</description><subject>Acidosis</subject><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Aged</subject><subject>Biology and Life Sciences</subject><subject>Brain natriuretic peptide</subject><subject>Cardiology</subject><subject>Cardiology and cardiovascular system</subject><subject>Care and treatment</subject><subject>Chest</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Cohort Studies</subject><subject>Comorbid patients</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Congestive heart failure</subject><subject>Demographic aspects</subject><subject>Diagnosis</subject><subject>Disease management</subject><subject>Dyspnea</subject><subject>Dyspnea - complications</subject><subject>Dyspnea - diagnosis</subject><subject>Edema</subject><subject>Emergencies</subject><subject>Emergency medical care</subject><subject>Emergency service</subject><subject>Emergency Service, Hospital</subject><subject>Female</subject><subject>France</subject><subject>Health care access</subject><subject>Heart failure</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - epidemiology</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Medical examination</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Peptides</subject><subject>Pleural effusion</subject><subject>Pneumonia</subject><subject>Pulmonary edema</subject><subject>Radiography</subject><subject>Radiography - statistics & numerical data</subject><subject>Reclassification</subject><subject>Renal function</subject><subject>Reproducibility</subject><subject>Respiration</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>ROC Curve</subject><subject>Shortness of breath</subject><subject>Statistics</subject><issn>1549-1676</issn><issn>1549-1277</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqVk89u1DAQxiMEoqXwBggsISF62MWO85cD0qotdKUVRS1wtRxnnLhK4sVOVt034_GYdLdVt9oDKAdH49_3jWfsCYLXjE4ZT9nHazu4TjbTZQvllFHKI5Y_CQ5ZHOUTlqTJ0wf_B8EL768pDXOa0-fBAecsjTMeHgZ_To2sOut7o8gSnLaulZ0CYjVRtqsAN2xHvLIOiOlKuCGwks0geyiJdrYlqkaGOFkaWzm5rNcEPYhUQw-kBul6oqVphls56Wsg0IKroFNrUsIS91vo-k9kRhz0zvolqN6sgEgsbe2N3yQZdd9nl7PT-dUZnqu2rn8ZPNOy8fBqux4FP7-c_Tg5nywuvs5PZouJSvOsnyS8LLNQSZ3ILI-TMCmZiiJdZBjnWidlyHjEpWY516EqNHBW8DjmaVSkNA9DfhS83fguG-vFtulehEme0IxnSYTEfEOUVl6LpTOtdGthpRG3AesqgWUa1YCALA214nkoMxVJmhWF5KpgRZRnIcvp6PV5m20o8F4V9sbJZsd0d6cztajsSqRJnMaMosHxxqB-JDufLcQYo5wiliYrhuyHbTJnfw94jaI1XkHTyA7sgDVGCaVZzMIY0XeP0P2d2FKVxGJNpy2eUY2mYpbENGNjnUhN9lD4JAALsh1og-EdfrqHx6-E1qi9guMdATI93PSVHLwX86vL_2C__Tt78WuXff-AxUFo-trbZhjHye-C0QZU-Pq9A31_a4yKcdDvOi3GQRfbQUfZm4cP5V50N9n8L8yvTtY</recordid><startdate>20201111</startdate><enddate>20201111</enddate><creator>Kobayashi, Masatake</creator><creator>Douair, Amine</creator><creator>Duarte, Kevin</creator><creator>Jaeger, Déborah</creator><creator>Giacomin, Gaetan</creator><creator>Bassand, Adrien</creator><creator>Jeangeorges, Victor</creator><creator>Abensur Vuillaume, Laure</creator><creator>Preud'homme, Gregoire</creator><creator>Huttin, Olivier</creator><creator>Zannad, Faiez</creator><creator>Rossignol, Patrick</creator><creator>Chouihed, Tahar</creator><creator>Girerd, Nicolas</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><scope>DOA</scope><scope>CZK</scope><orcidid>https://orcid.org/0000-0002-3631-9633</orcidid><orcidid>https://orcid.org/0000-0003-2527-8458</orcidid><orcidid>https://orcid.org/0000-0003-1531-7409</orcidid><orcidid>https://orcid.org/0000-0002-3278-2057</orcidid><orcidid>https://orcid.org/0000-0002-0292-0498</orcidid><orcidid>https://orcid.org/0000-0001-8708-1402</orcidid><orcidid>https://orcid.org/0000-0001-8009-3873</orcidid><orcidid>https://orcid.org/0000-0003-0008-2256</orcidid><orcidid>https://orcid.org/0000-0002-3583-7172</orcidid><orcidid>https://orcid.org/0000-0001-7456-1570</orcidid></search><sort><creationdate>20201111</creationdate><title>Diagnostic performance of congestion score index evaluated from chest radiography for acute heart failure in the emergency department: A retrospective analysis from the PARADISE cohort</title><author>Kobayashi, Masatake ; Douair, Amine ; Duarte, Kevin ; Jaeger, Déborah ; Giacomin, Gaetan ; Bassand, Adrien ; Jeangeorges, Victor ; Abensur Vuillaume, Laure ; Preud'homme, Gregoire ; Huttin, Olivier ; Zannad, Faiez ; Rossignol, Patrick ; Chouihed, Tahar ; Girerd, Nicolas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c798t-63dd82caf6a895626d1c44fb83dd3ff6d21343af193f2cbfe31b355374b709223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acidosis</topic><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Aged</topic><topic>Biology and Life Sciences</topic><topic>Brain natriuretic peptide</topic><topic>Cardiology</topic><topic>Cardiology and cardiovascular system</topic><topic>Care and treatment</topic><topic>Chest</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Cohort Studies</topic><topic>Comorbid patients</topic><topic>Comorbidity</topic><topic>Complications and side effects</topic><topic>Congestive heart failure</topic><topic>Demographic aspects</topic><topic>Diagnosis</topic><topic>Disease management</topic><topic>Dyspnea</topic><topic>Dyspnea - complications</topic><topic>Dyspnea - diagnosis</topic><topic>Edema</topic><topic>Emergencies</topic><topic>Emergency medical care</topic><topic>Emergency service</topic><topic>Emergency Service, Hospital</topic><topic>Female</topic><topic>France</topic><topic>Health care access</topic><topic>Heart failure</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - epidemiology</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Hospitals</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Medical examination</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Peptides</topic><topic>Pleural effusion</topic><topic>Pneumonia</topic><topic>Pulmonary edema</topic><topic>Radiography</topic><topic>Radiography - statistics & numerical data</topic><topic>Reclassification</topic><topic>Renal function</topic><topic>Reproducibility</topic><topic>Respiration</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>ROC Curve</topic><topic>Shortness of breath</topic><topic>Statistics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kobayashi, Masatake</creatorcontrib><creatorcontrib>Douair, Amine</creatorcontrib><creatorcontrib>Duarte, Kevin</creatorcontrib><creatorcontrib>Jaeger, Déborah</creatorcontrib><creatorcontrib>Giacomin, Gaetan</creatorcontrib><creatorcontrib>Bassand, Adrien</creatorcontrib><creatorcontrib>Jeangeorges, Victor</creatorcontrib><creatorcontrib>Abensur Vuillaume, Laure</creatorcontrib><creatorcontrib>Preud'homme, Gregoire</creatorcontrib><creatorcontrib>Huttin, Olivier</creatorcontrib><creatorcontrib>Zannad, Faiez</creatorcontrib><creatorcontrib>Rossignol, Patrick</creatorcontrib><creatorcontrib>Chouihed, Tahar</creatorcontrib><creatorcontrib>Girerd, Nicolas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Opposing Viewpoints Resource Center</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kobayashi, Masatake</au><au>Douair, Amine</au><au>Duarte, Kevin</au><au>Jaeger, Déborah</au><au>Giacomin, Gaetan</au><au>Bassand, Adrien</au><au>Jeangeorges, Victor</au><au>Abensur Vuillaume, Laure</au><au>Preud'homme, Gregoire</au><au>Huttin, Olivier</au><au>Zannad, Faiez</au><au>Rossignol, Patrick</au><au>Chouihed, Tahar</au><au>Girerd, Nicolas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic performance of congestion score index evaluated from chest radiography for acute heart failure in the emergency department: A retrospective analysis from the PARADISE cohort</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2020-11-11</date><risdate>2020</risdate><volume>17</volume><issue>11</issue><spage>e1003419</spage><epage>e1003419</epage><pages>e1003419-e1003419</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>PMCID: PMC7657510</notes><notes>We have read the journal's policy and the authors of this manuscript have the following competing interests: NG receives honoraria from Novartis and Boehringer. TC receives fees from Novartis for scientific board. FZ and PR are the cofounders of CardioRenal. FZ reports personal fees from Boehringer Ingelheim, Janssen, Novartis, Boston Scientific, Amgen, CVRx, AstraZeneca, Vifor Fresenius, Cardior, Cereno pharmaceutical, Applied Therapeutics, Merck, Bayer and Cellprothera, and is a founder of Cardiovascular Clinical Trialists. PR reports grants and personal fees from AstraZeneca, Bayer, CVRx, Fresenius, and Novartis, personal fees from Grunenthal, Servier, Stealth Peptides, Vifor Fresenius Medical Care Renal Pharma, Idorsia, NovoNordisk, Ablative Solutions, G3P, Corvidia and Relypsa. Other co-authors have declared that no competing interests exist.</notes><abstract>Congestion score index (CSI), a semiquantitative evaluation of congestion on chest radiography (CXR), is associated with outcome in patients with heart failure (HF). However, its diagnostic value in patients admitted for acute dyspnea has yet to be evaluated.
The diagnostic value of CSI for acute HF (AHF; adjudicated from patients' discharge files) was studied in the Pathway of dyspneic patients in Emergency (PARADISE) cohort, including patients aged 18 years or older admitted for acute dyspnea in the emergency department (ED) of the Nancy University Hospital (France) between January 1, 2015 and December 31, 2015. CSI (ranging from 0 to 3) was evaluated using a semiquantitative method on CXR in consecutive patients admitted for acute dyspnea in the ED. Results were validated in independent cohorts (N = 224). Of 1,333 patients, mean (standard deviation [SD]) age was 72.0 (18.5) years, 686 (51.5%) were men, and mean (SD) CSI was 1.42 (0.79). Patients with higher CSI had more cardiovascular comorbidities, more severe congestion, higher b-type natriuretic peptide (BNP), poorer renal function, and more respiratory acidosis. AHF was diagnosed in 289 (21.7%) patients. CSI was significantly associated with AHF diagnosis (adjusted odds ratio [OR] for 0.1 unit CSI increase 1.19, 95% CI 1.16-1.22, p < 0.001) after adjustment for clinical-based diagnostic score including age, comorbidity burden, dyspnea, and clinical congestion. The diagnostic accuracy of CSI for AHF was >0.80, whether alone (area under the receiver operating characteristic curve [AUROC] 0.84, 95% CI 0.82-0.86) or in addition to the clinical model (AUROC 0.87, 95% CI 0.85-0.90). CSI improved diagnostic accuracy on top of clinical variables (net reclassification improvement [NRI] = 94.9%) and clinical variables plus BNP (NRI = 55.0%). Similar diagnostic accuracy was observed in the validation cohorts (AUROC 0.75, 95% CI 0.68-0.82). The key limitation of our derivation cohort was its single-center and retrospective nature, which was counterbalanced by the validation in the independent cohorts.
In this study, we observed that a systematic semiquantified assessment of radiographic pulmonary congestion showed high diagnostic value for AHF in dyspneic patients. Better use of CXR may provide an inexpensive, widely, and readily available method for AHF triage in the ED.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33175832</pmid><doi>10.1371/journal.pmed.1003419</doi><orcidid>https://orcid.org/0000-0002-3631-9633</orcidid><orcidid>https://orcid.org/0000-0003-2527-8458</orcidid><orcidid>https://orcid.org/0000-0003-1531-7409</orcidid><orcidid>https://orcid.org/0000-0002-3278-2057</orcidid><orcidid>https://orcid.org/0000-0002-0292-0498</orcidid><orcidid>https://orcid.org/0000-0001-8708-1402</orcidid><orcidid>https://orcid.org/0000-0001-8009-3873</orcidid><orcidid>https://orcid.org/0000-0003-0008-2256</orcidid><orcidid>https://orcid.org/0000-0002-3583-7172</orcidid><orcidid>https://orcid.org/0000-0001-7456-1570</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1549-1676 |
| ispartof | PLoS medicine, 2020-11, Vol.17 (11), p.e1003419-e1003419 |
| issn | 1549-1676 1549-1277 1549-1676 |
| language | eng |
| recordid | cdi_plos_journals_2696083864 |
| source | Open Access: PubMed Central; Publicly Available Content Database |
| subjects | Acidosis Acute Disease Adolescent Aged Biology and Life Sciences Brain natriuretic peptide Cardiology Cardiology and cardiovascular system Care and treatment Chest Chronic obstructive pulmonary disease Cohort Studies Comorbid patients Comorbidity Complications and side effects Congestive heart failure Demographic aspects Diagnosis Disease management Dyspnea Dyspnea - complications Dyspnea - diagnosis Edema Emergencies Emergency medical care Emergency service Emergency Service, Hospital Female France Health care access Heart failure Heart Failure - diagnosis Heart Failure - epidemiology Hospitalization - statistics & numerical data Hospitals Human health and pathology Humans Life Sciences Male Medical examination Medicine and Health Sciences Middle Aged Mortality Patient outcomes Patients Peptides Pleural effusion Pneumonia Pulmonary edema Radiography Radiography - statistics & numerical data Reclassification Renal function Reproducibility Respiration Retrospective Studies Risk factors ROC Curve Shortness of breath Statistics |
| title | Diagnostic performance of congestion score index evaluated from chest radiography for acute heart failure in the emergency department: A retrospective analysis from the PARADISE cohort |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-21T23%3A32%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Diagnostic%20performance%20of%20congestion%20score%20index%20evaluated%20from%20chest%20radiography%20for%20acute%20heart%20failure%20in%20the%20emergency%20department:%20A%20retrospective%20analysis%20from%20the%20PARADISE%20cohort&rft.jtitle=PLoS%20medicine&rft.au=Kobayashi,%20Masatake&rft.date=2020-11-11&rft.volume=17&rft.issue=11&rft.spage=e1003419&rft.epage=e1003419&rft.pages=e1003419-e1003419&rft.issn=1549-1676&rft.eissn=1549-1676&rft_id=info:doi/10.1371/journal.pmed.1003419&rft_dat=%3Cgale_plos_%3EA650814982%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c798t-63dd82caf6a895626d1c44fb83dd3ff6d21343af193f2cbfe31b355374b709223%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2696083864&rft_id=info:pmid/33175832&rft_galeid=A650814982&rfr_iscdi=true |