{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:52:03Z","timestamp":1784170323366,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T00:00:00Z","timestamp":1658793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS024277"],"award-info":[{"award-number":["R01HS024277"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Guidelines recommend testing hospitalized patients with community\u2010acquired pneumonia (CAP) for <jats:italic>Legionella pneumophila<\/jats:italic> only if the infection is severe or risk factors are present. There are no validated models for predicting <jats:italic>Legionella<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To derive and externally validate a model to predict a positive Legionella test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting and Participants<\/jats:title><jats:p>Diagnostic study of adult inpatients with pneumonia using data from 177 US hospitals in the Premier Healthcare Database (training and hold\u2010out validation sets) and 12 Cleveland Clinic Health System (CCHS) hospitals (external validation set). We used multiple logistic regression to predict positive <jats:italic>Legionella<\/jats:italic> tests in the training set, and evaluated performance in both validation sets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome and Measures<\/jats:title><jats:p>The outcome was a positive <jats:italic>Legionella<\/jats:italic> test. Potential predictors included demographics and co\u2010morbidities, disease severity indicators, season, region, and presence of a local outbreak.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 166,689 patients hospitalized for pneumonia, 43,070 were tested for <jats:italic>Legionella<\/jats:italic> and 642 (1.5%) tested positive. The strongest predictors of a positive test were a local outbreak (odds ratio [OR], 3.4), June\u2013October occurrence (OR, 3.4), hyponatremia (OR, 3.3), smoking (OR, 2.4), and diarrhea (OR, 2.0); prior admission within 6 months (OR, 0.27) and chronic pulmonary disease (OR, 0.49) were associated with a negative test. Model <jats:italic>c<\/jats:italic>\u2010statistics were 0.79 in the Premier and 0.77 in the CCHS validation samples. High\u2010risk patients were only slightly more likely to have been tested than lower\u2010risk patients. Compared to actual practice, the model\u2010based testing strategy detected twice as many cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although <jats:italic>Legionella<\/jats:italic> is an uncommon cause of pneumonia, patient characteristics can identify individuals at high risk, allowing for more efficient testing.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.12919","type":"journal-article","created":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T16:19:56Z","timestamp":1658852396000},"page":"624-632","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A risk model to identify <i>Legionella<\/i> among patients admitted with community\u2010acquired pneumonia: A retrospective cohort study"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2063-1876","authenticated-orcid":false,"given":"Michael 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