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Better tackling SCI-AP requires a common understanding on how SCI-AP is defined. This survey examines clinical algorithms relevant for diagnosis and treatment of SCI-AP.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Setting<\/jats:title>\n                <jats:p>All departments for SCI-care in Germany.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The clinical decision-making on SCI-AP and the utility of the Centers for Disease Control and Prevention (CDC) criteria for diagnosis of \u2018clinically defined pneumonia\u2019 were assessed by means of a standardized questionnaire including eight case vignettes of suspected SCI-AP. The diagnostic decisions based on the case information were analysed using classification and regression trees (CART).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The majority of responding departments were aware of the CDC-criteria (88%). In the clinical vignettes, 38\u201381% of the departments diagnosed SCI-AP in accordance with the CDC-criteria and 7\u201341% diagnosed SCI-AP in deviation from the CDC-criteria. The diagnostic agreement was not associated with the availability of standard operating procedures for SCI-AP management in the departments. CART analysis identified radiological findings, fever, and worsened gas exchange as most important for the decision on SCI-AP. Frequently requested supplementary diagnostics were microbiological analyses, C-reactive protein, and procalcitonin. For empirical antibiotic therapy, the departments used (acyl-)aminopenicillins\/\u03b2-lactamase inhibitors, cephalosporins, or combinations of (acyl-)aminopenicillins\/\u03b2-lactamase inhibitors with fluoroquinolones or carbapenems.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This survey reveals a diagnostic ambiguity regarding SCI-AP despite the awareness of CDC-criteria and established SOPs. Heterogeneous clinical practice is encouraging the development of disease-specific guidelines for diagnosis and management of SCI-AP.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/s41393-020-0435-5","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T16:14:29Z","timestamp":1582042469000},"page":"873-881","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical decision-making on spinal cord injury-associated pneumonia: a nationwide survey in Germany"],"prefix":"10.1038","volume":"58","author":[{"given":"Claudia","family":"Druschel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramin R.","family":"Ossami Saidy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Grittner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claus P.","family":"Nowak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Meisel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus-Dieter","family":"Schaser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Niedeggen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6025-6564","authenticated-orcid":false,"given":"Thomas","family":"Liebscher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6832-9599","authenticated-orcid":false,"given":"Marcel A.","family":"Kopp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6784-4919","authenticated-orcid":false,"given":"Jan M.","family":"Schwab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,2,18]]},"reference":[{"key":"435_CR1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3171\/2012.4.AOSPINE1294","volume":"17","author":"RG Grossman","year":"2012","unstructured":"Grossman RG, Toups EG, Frankowski RF, Burau KD, Howley S. 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