scholarly journals Comparative study of CURB-65, Pneumonia Severity Index and IDSA/ATS scoring systems in community acquired pneumonia in an Indian tertiary care setting

2017 ◽  
Vol 4 (3) ◽  
pp. 693 ◽  
Author(s):  
S. Madhu ◽  
Sabu Augustine ◽  
Y. S. Ravi Kumar ◽  
Kauser Kauser M. M. ◽  
S. R. Vagesh Kumar ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Tertiary Care ◽  
Pneumonia Severity Index ◽  
Scoring Systems ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Class Iii ◽  
Pneumonia Severity ◽  
Icu Admission ◽  
Class Iv

Background: Few comparative studies regarding prognostic scoring systems for community acquired pneumonia (CAP) are available from Indian context.Methods: Hospital-based prospective study to test the comparison between confusion, urea, respiratory rate, blood pressure, age over 65 years (CURB-65), Pneumonia severity index (PSI) and infectious diseases society of America/American thoracic society criteria (IDSA/ATS) scoring systems in patients with community acquired pneumonia.Results: CURB-65 class ≥III, PSI class ≥IV and patients who needed admission to intensive care unit (ICU) based on IDSA/ATS criteria were having sensitivity of 41.7%, 91.7% and 87.5% in predicting ICU admission with a specificity of 89.5%, 59.2% and 73.7% respectively. Their sensitivity in predicting death were 44.4%, 88.9% and 83.3% with a specificity of 87.8%, 54.9% and 68.3% respectively. In both PSI score and IDSA/ATS criteria risk scoring systems, mortality rate, need for ICU admission increased progressively with increasing scores but CURB-65 score did not show this correlation. The PSI class ≥IV was more sensitive in predicting ICU admission than CURB-65 and IDSA/ATS criteria.Conclusions: PSI was most sensitive in both predicting ICU admission and death whereas CURB-65 is most specific in predicting ICU admission and death. But CURB-65 is least sensitive in both predicting ICU admission and death. Even though IDSA/ATS criteria did not have highest sensitivity and specificity as single criteria it had modest sensitivity and specificity in predicting ICU admission and death.

Community Acquired Pneumonia in Internal Medicine: A One-Year Retrospective Study Based on Pneumonia Severity Index

2005 ◽  
Vol 18 (3) ◽  
pp. 575-586 ◽  
Author(s):  
G. Riccioni ◽  
V. Dipietro ◽  
T. Staniscia ◽  
L. De Feudis ◽  
G. Traisci ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Cause Of Death ◽  
Pneumonia Severity Index ◽  
Hospital Setting ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Class Iii ◽  
Class V ◽  
Pneumonia Severity ◽  
The Usa

Community acquired pneumonia (CAP) represents the sixth cause of death and the first cause of death for an infectious disease in the USA. The aim of the present study is to evaluate how CAP is managed in a hospital setting, with particular attention to the wards of internal medicine, compared to the recommendations based and validated PSI (Pneumonia Severity Index). 42 subjects were included in the study, 25 males and 17 females. According to the PSI, nine (21%) patients were classified in class I, two (5%) in class II, ten (24%) in class III, fifteen (36%) in class IV and six (14%) in class V. Three patients died during the stay in the hospital (2 males and 1 female), all in the highest PSI class (V). According to the criteria used to evaluate the adequacy of the admission to the hospital, twentyeight patients were classified in the HRG, with an appropriate admission, whilst fourteen (33%) were in the LRG, with an inappropriate admission to the hospital. The data of the study confirm the validity of a PSI based strategy for the management of CAP since admittance to the hospital. This approach is not yet widely implemented in Italy, and a better dialogue between hospital and health system representatives would be convenient, to reduce costs and ensure the safety of patients affected by CAP.

scholarly journals PNEUMONIA SEVERITY INDEX (PSI)

2016 ◽  
Vol 23 (12) ◽  
pp. 1455-1461
Author(s):  
Maqsood Ahmed Khan ◽  
Syed Baqir Shyum Naqvi ◽  
Shazia Alam ◽  
Yousra Shafiq ◽  
Mudassar Hassan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Age Distribution ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Cross Sectional Study ◽  
Community Acquired Pneumonia ◽  
Class Iii ◽  
Cross Sectional ◽  
Pneumonia Severity ◽  
Study Results

Morbidity and mortality due to community acquired pneumonia has beenincreased in our country. Children and old age patients are mostly effected due to communityacquired pneumonia Study design: Cross sectional study. Setting: Patients hospitalized forCommunity acquired pneumonia in four different hospitals located at different areas werestudied. Period: Three years period from August 2011 to August 2014. Objectives: To assessdemographic profile, pneumonia severity index and length of stay of community acquiredpneumonia patients hospitalized at different hospitals in Karachi. Method: 800 patients bothmale and females patients were included in this study. Results: It was found that 480 (60%)were males and 320 (40%) were females, males were significantly more frequent (c2=0.48,p˂0.05) than the females patients. There was a significance difference in numbers of differentage group patients. According to the age distribution, there were 222(27.75%) from 1-5 years,which was the highest among the patients and there were 44(5.5%) from 81-90 years of agegroup patients, which was least among the different age group patients. According to thecomorbidity most of the patients were found without comorbidity there were 456(57%) patientspossess no comorbidity. Patients with comorbidity were 344(43%), and comorbidity was foundin patients with hypertension were 131(16.4%) and patients with diabetes were 105(13.1%) thesewere the two most commonly comorbidity disease found. According to the socioeconomicstatus (SES) status there were 482(60.25%) patients from lower SES class, 270(33.8%) patientfrom middle SES class and 54(6.8%) patients from high Socioeconomic class. patient with lowSES were much higher at hospital C and hospital D.(c2=127.88,p˂0.05). CAP is more frequentin married patients, married patients status were much higher at hospital C and hospital D(c2=60.31, p˂0.05). According to the PSI segregation there were 424(53%) patients from PSIclass I, 168(21%) were from PSI class II, 128(16%) patients were from PSI class III, 44(5.5%)were from class IV and 36(4.5%) were from PSI class V. Mean length of stay (LOS) was greaterat hospital C and D as compare to other two hospitals. Conclusion: CAP is frequent amongmales, low socio-economic, hypertensive individuals and patients from 1-5 years of age. Theshortest mean length found was 3.6days at hospital A and the longest mean length of stayfound was 7.6 days at hospital D.

Soluble form of suppression of tumorigenicity-2 predicts clinical stability of inpatients with community-acquired pneumonia

2021 ◽  
pp. 153537022110271
Author(s):  
Yifeng Zeng ◽  
Mingshan Xue ◽  
Teng Zhang ◽  
Shixue Sun ◽  
Runpei Lin ◽  
...  
Keyword(s):  
Regression Model ◽  
Predictive Value ◽  
Cox Regression ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Risk Classification ◽  
Soluble Form ◽  
Pneumonia Severity ◽  
Clinical Stability

The soluble form of the suppression of tumorigenicity-2 (sST2) is a biomarker for risk classification and prognosis of heart failure, and its production and secretion in the alveolar epithelium are significantly correlated with the inflammation-inducing in pulmonary diseases. However, the predictive value of sST2 in pulmonary disease had not been widely studied. This study investigated the potential value in prognosis and risk classification of sST2 in patients with community-acquired pneumonia. Clinical data of ninety-three CAP inpatients were retrieved and their sST2 and other clinical indices were studied. Cox regression models were constructed to probe the sST2’s predictive value for patients’ restoring clinical stability and its additive effect on pneumonia severity index and CURB-65 scores. Patients who did not reach clinical stability within the defined time (30 days from hospitalization) have had significantly higher levels of sST2 at admission ( P <  0.05). In univariate and multivariate Cox regression analysis, a high sST2 level (≥72.8 ng/mL) was an independent reverse predictor of clinical stability ( P < 0.05). The Cox regression model combined with sST2 and CURB-65 (AUC: 0.96) provided a more accurate risk classification than CURB-65 (AUC:0.89) alone (NRI: 1.18, IDI: 0.16, P < 0.05). The Cox regression model combined with sST2 and pneumonia severity index (AUC: 0.96) also provided a more accurate risk classification than pneumonia severity index (AUC:0.93) alone (NRI: 0.06; IDI: 0.06, P < 0.05). sST2 at admission can be used as an independent early prognostic indicator for CAP patients. Moreover, it can improve the predictive power of CURB-65 and pneumonia severity index score.

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