Community-acquired pneumonia: comparison of three mortality prediction scores in the emergency department,Neumonía adquirida en la comunidad: comparación de tres puntuaciones de predicción de mortalidad en el servicio de urgencias: comparación de tres puntuaciones de predicción de mortalidad en el servicio de urgencias

Translated title of the contribution: Community-acquired pneumonia: comparison of three mortality prediction scores in the emergency department

Carolina Hincapié, Johana Ascuntar, Alba León, Fabián Jaimes*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
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Abstract

Background: qSOFA is a score to identify patients with suspected infection and risk of complications. Its criteria are like those evaluated in prognostic scores for pneumonia (CRB-65-CURB-65), but it is not clear which is best for predicting mortality and admission to the ICU.

Objective: Compare three scores (CURB-65, CRB-65 and qSOFA) to determine the best tool to identify emergency department patients with pneumonia at increased risk of mortality or intensive care unit (ICU) admission.

Methods: Secondary analysis of three prospective cohorts of patients hospitalized with diagnosis of pneumonia in five Colombian hospitals. Validation and comparison of the score´s accuracies were performed by means of discrimination and calibration measures.

Results: Cohorts 1, 2 and 3 included 158, 745 and 207 patients, with mortality rates of 32.3%, 17.2% and 18.4%, and admission to ICU was required for 52.5%, 43.5% and 25.6%, respectively. The best AUC-ROC for mortality was for CURB-65 in cohort 3 (AUC-ROC=0.67). The calibration was adequate (p>0.05) for the three scores.

Conclusions: None of these scores proved to be an appropriate predictor for mortality and admission to the ICU. Furthermore, the CRB 65 exhibited the lowest discriminative ability.

Translated title of the contributionCommunity-acquired pneumonia: comparison of three mortality prediction scores in the emergency department
Original languageSpanish
Article numbere2044287
Number of pages16
JournalColombia Medica
Volume52
Issue number4
DOIs
Publication statusPublished - 2021
Externally publishedYes

Keywords

  • clinical decision rules
  • mortality
  • pneumonia
  • Sepsis

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