Performance of the Pneumonia Shock Scale for Predicting Clinical Outcomes in Pneumonia
Keywords:
pneumonia; Pneumonia Shock score; CURB-65; MortalityAbstract
Introduction: the initial assessment of the severity of the patient with Community-Acquired Pneumonia (CAP) is a key point in deciding the site of care and for making management decisions, as well as for establishing complications and prognosis. Currently, comparative studies using the Pneumonia Shock Score vs CURB-65 are still scarce.
Objective: evaluate the performance and performance of the Pneumonia Shock Score in comparison to the CURB-65 in subjects with and without severe CAP as a predictor of the need for mechanical ventilation, in-hospital mortality, and 30-day mortality.
Methodology: a retrospective cohort study in subjects with a diagnosis of CAP and with all the information necessary for the complete calculation of the Pneumonia Shock Score and CURB-65. CAP was defined according to the guidelines of the American Thoracic Society / British Thoracic Society. The following outcomes were considered: in-hospital mortality and 30-day mortality, as independent variables the clinical findings, history, measurement of vital signs, laboratory findings, arterial blood gas values, and diagnostic images.
Results: 1907 subjects entered the definitive analysis for the Pneumonia Shock and CURB-65 scores, 301 patients died during hospitalization and 30-day follow-up. In the present cohort, the average age was 70.5 years (SD 19.44) and 61% of the population were men. The sensitivity turned out to be higher for the CURB-65 score in in-hospital mortality (83.39%) and 30-day follow-up mortality (82.87%). The Pneumonia Shock Score has a curve of receiver operating characteristics for in-hospital and 30-day mortality of 0.748 (95% CI: 0.718-0.778, p <0.001) and 0.739 (95% CI: 0.709-0.769, p <0.001), respectively.
Conclusion: The Pneumonia Shock Score has a similar performance to the CURB-65 for the prediction of mortality in patients with CAP admitted to the intensive care unit.
Downloads
References
Eshwara VK, Mukhopadhyay C, Rello J. Community-acquired bacterial pneumonia in adults: An update. Indian J Med Res. 2020 Apr;151(4):287-302. doi: 10.4103/ijmr.IJMR_1678_19.
Ticona JH, Zaccone VM, McFarlane IM. Community-Acquired Pneumonia: A Focused Review. Am J Med Case Rep. 2021;9(1):45-52. doi: 10.12691/ajmcr-9-1-12.
Nair GB, Niederman MS. Updates on community acquired pneumonia management in the ICU. Pharmacol Ther. 2021 Jan; 217:107663. doi: 10.1016/j.pharmthera.2020.107663.
Olson G, Davis AM. Diagnosis and Treatment of Adults with Community-Acquired Pneumonia. JAMA. 2020 Mar 3;323(9):885-886. doi: 10.1001/jama.2019.21118.
DeLaney M, Khoury C. Community-acquired pneumonia in the emergency department. Emerg Med Pract. 2021 Feb;23(2):1-24.
Fukuyama H, Ishida T, Tachibana H, Nakagawa H, Iwasaku M, Saigusa M, Yoshioka H, Arita M, Hashimoto T. Validation of scoring systems for predicting severe community-acquired pneumonia. Intern Med. 2011;50(18):1917-22. doi: 10.2169/internalmedicine.50.5279.
Carmo TA, Ferreira IB, Menezes RC, Telles GP, Otero ML, Arriaga MB, Fukutani KF, Neto LP, Agareno S, Filgueiras Filho NM, Andrade BB, Akrami KM. Derivation and Validation of a Novel Severity Scoring System for Pneumonia at Intensive Care Unit Admission. Clin Infect Dis. 2021 Mar 15;72(6):942-949. doi: 10.1093/cid/ciaa183.
Ferreira-Coimbra J, Sarda C, Rello J. Burden of Community-Acquired Pneumonia and Unmet Clinical Needs. Adv Ther. 2020 Apr;37(4):1302-1318. doi: 10.1007/s12325-020-01248-7.
Pletz MW, Blasi F, Chalmers JD, Dela Cruz CS, Feldman C, Luna CM, Ramirez JA, Shindo Y, Stolz D, Torres A, Webb B, Welte T, Wunderink R, Aliberti S. International Perspective on the New 2019 American Thoracic Society/Infectious Diseases Society of America Community-Acquired Pneumonia Guideline: A Critical Appraisal by a Global Expert Panel. Chest. 2020 Nov;158(5):1912-1918. doi: 10.1016/j.chest.2020.07.089.
Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, Cooley LA, Dean NC, Fine MJ, Flanders SA, Griffin MR, Metersky ML, Musher DM, Restrepo MI, Whitney CG. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7): e45-e67. doi: 10.1164/rccm.201908-1581ST.
Ilg A, Moskowitz A, Konanki V, Patel PV, Chase M, Grossestreuer AV, Donnino MW. Performance of the CURB-65 Score in Predicting Critical Care Interventions in Patients Admitted with Community-Acquired Pneumonia. Ann Emerg Med. 2019 Jul;74(1):60-68. doi: 10.1016/j.annemergmed.2018.06.017.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009 Apr;42(2):377-81. doi: 10.1016/j.jbi.2008.08.010.
Marti C, Garin N, Grosgurin O, Poncet A, Combescure C, Carballo S, Perrier A. Prediction of severe community-acquired pneumonia: a systematic review and meta-analysis. Crit Care. 2012 Jul 27;16(4): R141. doi: 10.1186/cc11447.
Vazquez Guillamet MC, Kollef MH. Next Steps in Pneumonia Severity Scores. Clin Infect Dis. 2021 Mar 15;72(6):950-952. doi: 10.1093/cid/ciaa184.
Lara A, Ruiz G, Sotomayor L, Manrique C, Castell C. Factores predictores de severidad en pacientes con diagnóstico de neumonía adquirida en la comunidad y su relación con el requerimiento de cuidado intensivo. Acta Colombiana de Cuidado Intensivo, 9(1),8-13. Disponible en: https://www.anestesianet.com/actacci/ActaColCuidadoCriticoMar09.pdf#page=13.
Sanz Herrero F, Malanda NM, Veiga BM, Sanjuán López MP. Nuevos retos en la neumonía comunitaria [New challenges in community-acquired pneumonia]. Arch Bronconeumol. 2010 Oct;46 Suppl 6:22-6. Spanish. doi: 10.1016/S0300-2896(10)70039-9.
Wrotek A, Jackowska T. Hyponatremia in children hospitalized due to pneumonia. Adv Exp Med Biol. 2013; 788:103-8. doi: 10.1007/978-94-007-6627-3_16.
Ito A, Ishida T. Diagnostic markers for community-acquired pneumonia. Ann Transl Med. 2020 May;8(9):609. doi: 10.21037/atm.2020.02.182.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 AVFT – Archivos Venezolanos de Farmacología y Terapéutica
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
