Performance of the PSI and CURB-65 scoring systems in predicting 30-day mortality in healthcare-associated pneumonia
Performance of the PSI and CURB-65 scoring systems in predicting 30-day mortality in healthcare-associated pneumonia
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DOI：
10.1016/j.medcli.2017.06.044
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发表时间：
2018-02-09
期刊：
影响因子：
3.9
通讯作者：
Trujillo-Hernandez, Benjamin
中科院分区：
文献类型：
--
作者：
Murillo-Zamora, Efren;Medina-Gonzalez, Alfredo;Trujillo-Hernandez, Benjamin
简介：卫生保健相关性肺炎（HCAP）是医院感染的主要原因，并与高死亡率相关。本研究旨在评估肺炎严重程度指数（PSI）和混乱，尿素，呼吸频率，血压，年龄>= 65（CURB-65）系统在预测30天死亡率在HCAP成人patients.Patients和方法的性能：进行了横断面研究，并从109个非免疫功能低下的个人年龄> 18岁的数据进行了分析。HCAP的临床诊断包括患者入院后> 48小时存在放射学浸润。计算PSI和CURB-65评分，并估计性能指标。使用汇总统计量描述研究样本。PSI和CURB-65评分分别计算20和5个标准的基础上，和性能指标的筛选tools.Results：总的30天死亡率为59.6%。在每个给定的阈值，PSI的灵敏度较高，但表现出较低的特异性比CURB-65，并观察到最高的约登指数（0.392）在截止V的PSI。ROC曲线下面积为0.737（95% CI：0.646-0.827）和0.698（95% CI：0.600-0.797），分别使用PSI和CURB-65系统（P=.323）.结论：我们的研究结果表明，PSI和CURB-65的性能是合理的预测30-成人HCAP患者的日死亡率，并可用于医疗机构。(C)2017 Elsevier Espana，S.LU. All rights reserved.
Introduction: Healthcare-associated pneumonia (HCAP) is the leading cause of infection in a hospital setting and is associated with a high mortality rate. This study aimed to evaluate the performance of the pneumonia severity index (PSI) and confusion, urea, respiratory rate, blood pressure, age >= 65 (CURB-65) systems in predicting 30-day mortality in HCAP in adult patients.Patients and methods: A cross-sectional study took place and data from 109 non-immunocompromised individuals aged > 18 years were analyzed. The clinical diagnosis of HCAP included the presence of radiographic infiltrates in patients > 48 hours after hospital admission. The PSI and CURB-65 scores were calculated and performance measures were estimated. Summary statistics were used to describe the study sample. The PSI and CURB-65 scores were calculated based on 20 and 5 criteria, respectively, and the performance indicators of the screening tools were estimated.Results: The overall 30-day mortality was 59.6%. At every given threshold, PSI sensitivity was higher, but showed a lower specificity than the CURB-65, and the highest Youden index (0.392) was observed at cut-off V in the PSI. The area under the ROC curve was 0.737 (95% CI: 0.646-0.827) and 0.698 (95% CI: 0.600-0.797) using the PSI and CURB-65 systems, respectively (P=.323).Conclusion: Our findings suggest that the performance of the PSI and CURB-65 is reasonable for predicting 30-day mortality in adult HCAP patients and may be used in healthcare settings. (C) 2017 Elsevier Espana, S.LU. All rights reserved.