Gruson et al identified clinical factors associated with a patient with a hematologic malignancy and pneumonia being admitted to the ICU. These can help identify a patient who may require closer monitoring and more aggressive management. The authors are from university Hospitals in Pessac and Bordeaux, France.


Predictors from multivariate analysis:

(1) a decrease in the percent SaO2 by >= 10%

(2) high flow rates of supplementary nasal oxygen


Rules developed to identify a patient requiring admission to the ICU:

(1) nasal oxygen flow rate >= 3 L/min to maintain SpO2 >= 92%

(2) 2 or more involved quadrants on the first chest X-ray (maximum 4)



(1) The first rule had a sensitivity of 76% and specificity of 96%.

(2) The 2 rules together had a sensitivity of 84% and specificity of 97%. This had a PPV of 91% and a NPV of 96%.


Additional risk factors for ICU admission:

(1) presence of hepatic failure

(2) Gram-negative bacteria isolated in blood cultures (pathogenic Gram-positive bacteria should also be significant)

(3) 2 or more organ failures

(4) low PaO2 (mean 62 mm Hg)


To read more or access our algorithms and calculators, please log in or register.