Pneumonia Severity Index (PSI), CURB-65, and mortality in hospitalized elderly patients with aspiration pneumonia
Pneumonia Severity Index (PSI), CURB-65, and mortality in hospitalized elderly patients with aspiration pneumonia
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DOI：
10.1007/s00391-011-0184-3
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发表时间：
2011-08-01
影响因子：
1.2
通讯作者：
Thiem, U.
中科院分区：
文献类型：
--
作者：
Heppner, H. J.;Sehlhoff, B.;Thiem, U.
背景老年患者吸入性肺炎的发病率和死亡率较高。为了提供适应风险的医疗护理，有必要为这些患者建立有效的预后工具。两种公认的评分对评估社区获得性肺炎（CAP）预后的价值，即，CURB-65和肺炎严重指数（PSI），在老年吸入性肺炎住院患者进行了评估。使用PSI和CURB-65对2001年至2005年期间在一个单中心因吸入性肺炎住院的209例患者进行了评价。为了比较发病率和死亡率，我们分析了一个同样大的CAP住院患者组。吸入性肺炎患者的平均年龄为76.7 ± 13.4岁，104例（49.8%）为女性。吸入性肺炎患者入院时更常表现出癌症、低血压和低血三钠的病史。死亡率明显高于CAP患者（39.2% vs. 16.3%）。CURB-65评分为3-5分与0-2分相比，死亡率的比值比（OR）为1.03（95% CI 0.59; 1.79）。在CAP病例中，OR显示风险在统计学上显著增加（OR 2.50; 95% CI 1.04; 6.06），CURB-65评分为3-5分vs. 0-2分）。在吸入性肺炎中，PSI显示出在高风险类别中死亡率增加的趋势。在老年吸入性肺炎住院患者中，CURB-65和PSI没有预后价值。
Background. Aspiration pneumonia is associated with a high morbidity and mortality in elderly patients. In order to provide risk-adapted medical care, it is necessary to establish valid prognostic tools for these patients.Objective. The value of two well-established scores to assess prognosis in community-acquired pneumonia (CAP), i.e., CURB-65 and the Pneumonia Severity Index (PSI), was evaluated in elderly patients hospitalized for aspiration pneumonia.Material and methods. A total of 209 patients hospitalized with aspiration pneumonia between 2001 and 2005 in a single center were evaluated using PSI and CURB-65. For comparison of morbidity and mortality, an equally large group of inpatients with CAP was analyzed.Results. The mean age of patients with aspiration pneumonia was 76.7+/-13.4 years, and 104 (49.8 %) were female. Patients with aspiration pneumonia more frequently showed a history of cancer, hypotension, and hyponatriemia on admission. Mortality was clearly higher in comparison to patients with CAP (39.2% vs. 16.3%). The Odds Ratio (OR) for mortality was 1.03 (95% CI 0.59; 1.79) for a CURB-65 score of 3-5 points compared to 0-2 points. In cases of CAP, OR showed a statistically significant increase of risk (OR 2.50; 95% CI 1.04; 6.06), for CURB-65 scores of 3-5 points vs. 0-2 points). In aspiration pneumonia, the PSI showed a trend towards increasing mortality within higher risk class.Conclusions. In geriatric patients hospitalized with aspiration pneumonia, CURB-65 and PSI have no prognostic value.