Eduardo Tuta-Quintero, Alirio Rodrigo Bastidas Goyes, Gabriela Guerrón-Gómez, María C Martínez, Daniela Torres, Carolina Schloss, Julian Camacho, Gabriela Bonilla, Daniela Cepeda, Paula Romero, Yuli Fuentes, Esteban Garcia, David Acosta, Santiago Rodríguez, David Alvarez, Luis F Reyes
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The areas under receiver operating characteristic curves (ROC-curves) were calculated for the outcome of survival or death at 30 days using the scores obtained for each of the analyzed questionnaires.</p><p><strong>Results: </strong>A total of 7454 potentially eligible patients were included, with 4350 in the final analysis, of whom 15.2% (662/4350) died within 30 days. The average age was 65.4 years (SD: 21.31), and 59.5% (2563/4350) were male. Chronic kidney disease was 3.7% (9.2% vs. 5.5%; p < 0.001) (OR: 1.85) higher in subjects who died compared to those who survived. Among the patients who died, 33.2% (220/662) presented septic shock compared to 7.3% (271/3688) of the patients who survived (p < 0.001). The best performances at 30 days were shown by the following scores: PSI, SMART-COP and CURB 65 scores with the areas under ROC-curves of 0.83 (95% CI: 0.8-0.85), 0.75 (95% CI: 0.66-0.83), and 0.73 (95% CI: 0.71-0.76), respectively. The RS with the lowest performance was SIRS with the area under ROC-curve of 0.53 (95% CI: 0.51-0.56).</p><p><strong>Conclusion: </strong>The PSI, SMART-COP and CURB 65, demonstrated the best diagnostic performances for predicting 30-day mortality in patients diagnosed with CAP. 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Among the patients who died, 33.2% (220/662) presented septic shock compared to 7.3% (271/3688) of the patients who survived (p < 0.001). The best performances at 30 days were shown by the following scores: PSI, SMART-COP and CURB 65 scores with the areas under ROC-curves of 0.83 (95% CI: 0.8-0.85), 0.75 (95% CI: 0.66-0.83), and 0.73 (95% CI: 0.71-0.76), respectively. The RS with the lowest performance was SIRS with the area under ROC-curve of 0.53 (95% CI: 0.51-0.56).</p><p><strong>Conclusion: </strong>The PSI, SMART-COP and CURB 65, demonstrated the best diagnostic performances for predicting 30-day mortality in patients diagnosed with CAP. 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引用次数: 0
摘要
背景:风险评分有助于评估社区获得性肺炎(CAP)患者的死亡风险:风险评分有助于评估社区获得性肺炎(CAP)患者的死亡风险。尽管风险评分很有用,但同时比较各种风险评分的证据却很少。本研究旨在评估和比较文献中报道的用于预测成人 CAP 患者 30 天死亡率的多种风险评分:哥伦比亚两家医院对确诊为 CAP 的患者进行了一项回顾性队列研究。结果:总共有 7454 名潜在的 CAP 患者被确诊为 CAP 患者,他们的死亡率均在 30 天内死亡:共纳入了 7454 名可能符合条件的患者,最终分析结果为 4350 人,其中 15.2%(662/4350)的患者在 30 天内死亡。平均年龄为 65.4 岁(标度:21.31),59.5%(2563/4350)为男性。慢性肾病患者占 3.7%(9.2% vs. 5.5%;P 结论:慢性肾病患者占 3.7%(9.2% vs. 5.5%;PPSI、SMART-COP 和 CURB 65 在预测确诊为 CAP 患者的 30 天死亡率方面具有最佳诊断性能。死亡患者的合并症和并发症负担较重。
Comparison of performances between risk scores for predicting mortality at 30 days in patients with community acquired pneumonia.
Background: Risk scores facilitate the assessment of mortality risk in patients with community-acquired pneumonia (CAP). Despite their utilities, there is a scarcity of evidence comparing the various RS simultaneously. This study aims to evaluate and compare multiple risk scores reported in the literature for predicting 30-day mortality in adult patients with CAP.
Methods: A retrospective cohort study on patients diagnosed with CAP was conducted across two hospitals in Colombia. The areas under receiver operating characteristic curves (ROC-curves) were calculated for the outcome of survival or death at 30 days using the scores obtained for each of the analyzed questionnaires.
Results: A total of 7454 potentially eligible patients were included, with 4350 in the final analysis, of whom 15.2% (662/4350) died within 30 days. The average age was 65.4 years (SD: 21.31), and 59.5% (2563/4350) were male. Chronic kidney disease was 3.7% (9.2% vs. 5.5%; p < 0.001) (OR: 1.85) higher in subjects who died compared to those who survived. Among the patients who died, 33.2% (220/662) presented septic shock compared to 7.3% (271/3688) of the patients who survived (p < 0.001). The best performances at 30 days were shown by the following scores: PSI, SMART-COP and CURB 65 scores with the areas under ROC-curves of 0.83 (95% CI: 0.8-0.85), 0.75 (95% CI: 0.66-0.83), and 0.73 (95% CI: 0.71-0.76), respectively. The RS with the lowest performance was SIRS with the area under ROC-curve of 0.53 (95% CI: 0.51-0.56).
Conclusion: The PSI, SMART-COP and CURB 65, demonstrated the best diagnostic performances for predicting 30-day mortality in patients diagnosed with CAP. The burden of comorbidities and complications associated with CAP was higher in patients who died.
期刊介绍:
BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.