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Bilateral Pleural Effusion and Mortality: How Does This Compare With Other Risk Factors?-Reply

Peggy Hasley, MD
Arch Intern Med. 1997;157(11):1267-1268. doi:10.1001/archinte.1997.00440320177022.
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The comments of Jackson, Malik, and Peard regarding our article' are appreciated. Our original multivariate analyses carefully controlled for patient demographic characteristics (eg, age), physical examination findings (eg, abnormal vital signs), comorbid illnesses (eg, active cancer), high-risk pneumonia etiology (eg, staphylococcal or Gram-negative rod pneumonia), and abnormal laboratory findings (eg, arterial hypoxemia), with a known association with mortality in patients with community-acquired pneumonia.2,3 In addition to the significant independent association of bilateral pleural effusions with mortality (odds ratio, 2.8; 95% confidence interval [CI], 1.4-5.8), the results of multivariate analysis indicated 9 nonradiographic factors with an independent association with mortality: age, confusion, active cancer, neuromuscular disease, renal insufficiency, cerebrovascular disease, a high-risk microbiologic etiology, arterial hypoxemia (PO2, <60 mm Hg), and a white blood cell count less than 4*109/L, with multivariate odds ratios ranging from 1.05 (95% CI, 1.03-1.07) per 1 year of age to 4.5 (95% CI, 2.0-10.3)


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