Diagnostic accuracy of clinical pulmonary infection score for ventilator-associated pneumonia: a meta-analysis

Respir Care. 2011 Aug;56(8):1087-94. doi: 10.4187/respcare.01097. Epub 2011 Feb 9.


Objective: To assess the diagnostic accuracy of the clinical pulmonary infection score in the diagnosis of ventilator-associated pneumonia in mechanically ventilated patients.

Methods: We searched PubMed and the Cochrane database, and included only studies that compared clinical pulmonary infection score with quantitative microbiological analysis of samples for diagnosing ventilator-associated pneumonia. We constructed 2-by-2 tables of diagnostic accuracy from each article, and meta-analyzed the results by pooling estimates of sensitivity, specificity, likelihood ratio for positive index test, likelihood ratio for negative index test, diagnostic odds ratio, and 95% confidence intervals.

Results: Thirteen studies met the inclusion criteria. The pooled estimates for sensitivity and specificity for clinical pulmonary infection score were 65% (95% CI 61-69%) and 64% (95% CI 60-67%), respectively. The combined diagnostic odds ratio was 4.85 (95% CI 2.42-9.71) and the area under the curve was 0.748 (95% CI 0.65-0.85).

Conclusions: The diagnostic performance of the clinical pulmonary infection score for ventilator-associated pneumonia is moderate. However, the clinical pulmonary infection score is simple and easy to perform, and may still be useful in diagnosing ventilator-associated pneumonia.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Bronchoalveolar Lavage Fluid / microbiology
  • Cross Infection / diagnosis*
  • Cross Infection / drug therapy
  • Humans
  • Intensive Care Units
  • Pneumonia, Ventilator-Associated / diagnosis*
  • Pneumonia, Ventilator-Associated / drug therapy
  • Reproducibility of Results
  • Respiration, Artificial / adverse effects*
  • Severity of Illness Index


  • Anti-Bacterial Agents