Criteria for clinical stability in hospitalised patients with community-acquired pneumonia

The American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) suggested two sets of criteria in 2001 and 2007 to define clinical stability (CS) in community-acquired pneumonia (CAP). We aim to evaluate the level of agreement between these two sets of criteria and how well they can predict clinical outcomes.A retrospective cohort study of 487 consecutive patients hospitalised with CAP. Level of agreement was tested using a survival curve analysis, while prediction of outcomes at 30-day follow-up was evaluated through receiver-operator curves (ROC).A discrepancy between ATS 2001 and ATS/IDSA 2007 criteria in identifying CS was detected in 62% of the patients. The median (IQR) time to CS was 2 (1-4) days based on ATS 2001 and 3 (2-5) days based on ATS/IDSA 2007 criteria (p=0.012). The daily distribution of patients who reached CS evaluated with both sets was different (p=0.002). The ROC analysis showed an area under the curve of 0.705 for the ATS 2001 criteria and 0.714 for ATS/IDSA 2007 criteria, p=0.645.ATS 2001 and ATS/IDSA 2007 criteria for CS in hospitalised patients with CAP are clinically equivalent and both can be used in clinical practice as well as in clinical research