PMID- 22052393
OWN - NLM
STAT- MEDLINE
DCOM- 20111222
LR  - 20151119
IS  - 0716-1018 (Print)
IS  - 0716-1018 (Linking)
VI  - 28
IP  - 4
DP  - 2011 Aug
TI  - [Severity scores for predicting clinically relevant outcomes for immunocompetent 
      adult patients hospitalized with community-acquired pneumococcal pneumonia].
PG  - 303-9
AB  - Streptococcus pneumoniae is the main cause of community-acquired pneumonia (CAP) 
      in adults. OBJECTIVES: To compare accuracy and discriminatory power of three 
      validated rules for predicting clinically relevant adverse outcomes in patients 
      hospitalized with community-acquired pneumococcal pneumonia. MEASUREMENTS: We 
      prospectively compared the pneumonia severity index (PSI), British Thoracic 
      Society score (CURB-65) and severe CAP score (SCAP) in a cohort of 151 
      consecutive immunocompetent adult patients hospitalized with pneumococcal 
      pneumonia. Major adverse outcomes were admission to ICU, need for mechanical 
      ventilation, in-hospital complications and 30-day mortality. Mean hospital length 
      of stay (LOS) was also evaluated. The predictive indexes were compared based on 
      sensitivity, specificity, and area under the curve of the receiver operating 
      characteristic. RESULTS: The mean age of 151 immunocompetent adult patients 
      hospitalized with pneumococcal pneumonia was 64 years (range, 16 to 92); 58% were 
      male, 75% had comorbidities, 26% were admitted to the intensive care unit and 9% 
      needed mechanical ventilation. The rate of all adverse outcomes and hospital LOS 
      increased directly with increasing PSI, CURB-65 and SCAP scores. The three 
      severity scores allowed us to predict the risk of in-hospital complications and 
      30-day mortality. The PSI score was more sensitive and the SCAP was more specific 
      to predict in-hospital complications and the risk of death. However, the SCAP was 
      more sensitive and specific in predicting the use of mechanical ventilation. 
      CONCLUSION: The severity scores validated in the literature allow us to predict 
      the risk of complications and death in adult patients hospitalized with 
      pneumococcal pneumonia. Nevertheless, the clinical indexes differ in their 
      sensitivity, specificity and discriminatory power to predict different adverse 
      events.
FAU - Saldias, Fernando
AU  - Saldias F
AD  - Facultad de Medicina, Departamento de Enfermedades RespiratoriasPontificia 
      Universidad Catolica de Chile, Santiago, Chile. fsaldias@med.puc.cl
FAU - Diaz, Orlando
AU  - Diaz O
LA  - spa
PT  - English Abstract
PT  - Journal Article
TT  - Indices predictores de eventos adversos en el adulto inmunocompetente 
      hospitalizado por neumonia neumococcica adquirida en la comunidad.
PL  - Chile
TA  - Rev Chilena Infectol
JT  - Revista chilena de infectologia : organo oficial de la Sociedad Chilena de 
      Infectologia
JID - 9305754
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Community-Acquired Infections/mortality
MH  - Critical Care
MH  - Epidemiologic Methods
MH  - Female
MH  - Humans
MH  - *Immunocompetence
MH  - Male
MH  - Middle Aged
MH  - Pneumonia, Pneumococcal/*mortality
MH  - Prognosis
MH  - Respiration, Artificial/adverse effects
MH  - Young Adult
EDAT- 2011/11/05 06:00
MHDA- 2011/12/23 06:00
CRDT- 2011/11/05 06:00
PHST- 2011/11/05 06:00 [entrez]
PHST- 2011/11/05 06:00 [pubmed]
PHST- 2011/12/23 06:00 [medline]
AID - S0716-10182011000500001 [pii]
PST - ppublish
SO  - Rev Chilena Infectol. 2011 Aug;28(4):303-9.