Performances of prognostic scoring systems in patients with healthcare-associated pneumonia.
Clin Infect Dis
; 56(5): 625-32, 2013 Mar.
Article
em En
| MEDLINE
| ID: mdl-23155150
ABSTRACT
BACKGROUND:
There are limited data on the performance of the pneumonia severity index (PSI) and CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥65) score, which were originally developed for community-acquired pneumonia (CAP), for patients with healthcare-associated pneumonia (HCAP).METHODS:
The performances of PSI and CURB-65 were retrospectively evaluated in patients with HCAP compared to patients with CAP using prospectively collected data between January 2008 and December 2010.RESULTS:
In total, 938 patients hospitalized with pneumonia were eligible for this study, consisting of 519 (55%) with CAP and 419 (45%) with HCAP. The PSI and CURB-65 scores had similar trends of increasing mortality with worsening risk class in both the HCAP and CAP groups. In the HCAP group, however, the low-risk patients identified using CURB-65 had a higher aggregate 30-day mortality compared with the low-risk patients identified using PSI. Although the performances of PSI and CURB-65 in the HCAP group showed similar trends to those observed in the CAP group, the estimated areas under the receiver operating characteristic curve for PSI (0.679, 95% confidence interval [CI], .619-.739) and CURB-65 (0.599, 95% CI, .522-.675) in the HCAP group were significantly lower than those in the CAP group (0.835, 95% CI, .768-.759 for PSI and .686-.832 for CURB-65).CONCLUSIONS:
The performances of PSI and CURB-65 for predicting 30-day mortality in patients with HCAP were comparable to those in patients with CAP. However, the discriminatory powers of PSI and CURB-65 for 30-day mortality were significantly lower in the HACP group than those in the CAP group.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonia
/
Índice de Gravidade de Doença
/
Infecções Comunitárias Adquiridas
/
Antibacterianos
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article