Adverse event prediction in immunocompetent adult patients hospitalized with community-acquired pneumonia

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dc.contributor.authorSaldias Penafiel, Fernando
dc.contributor.authorUribe Monasterio, Javier
dc.contributor.authorGassmann Poniachik, Javiera
dc.contributor.authorCanelo Lopez, Alejandro
dc.contributor.authorDiaz Patino, Orlando
dc.date.accessioned2024-01-10T12:04:08Z
dc.date.available2024-01-10T12:04:08Z
dc.date.issued2017
dc.description.abstractBackground: Community-acquired pneumonia (CAP) causes significant morbidity and mortality in adults. Aim: To compare the accuracy of four validated rules for predicting adverse outcomes in patients hospitalized with CAP. Patients and Methods: We compared the pneumonia severity index (PSI), British Thoracic Society score (CURB-65), SMART-COP and severe CAP score (SCAP) in 659 immunocompetent adult patients aged 18 to 101 years, 52% male, hospitalized with CAP. Major adverse outcomes were: admission to ICU, need for mechanical ventilation (MV), 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 curve. Results: Of the studied patients, 77% had comorbidities, 23% were admitted to the intensive care unit and 12% needed mechanical ventilation. The rate of all adverse outcomes and hospital LOS increased directly with increasing PSl, CURB-65, SMART-COP and SCAP scores. The sensitivity, specificity and area under the curve of the prognostic indexes to predict adverse events were: Admission to ICU (PSI: 0.48, 0.84 and 0.73; SMART-COP: 0.97, 0.23 and 0.75; SCAP: 0.57, 0.81 and 0.76); use of MV (PSI: 0.44, 0.84 and 0.75; SMART-COP: 0.96, 0.35 and 0.84; SCAR 0.53, 0.87 and 0.78); 30-days mortality (PSI: 0.45, 0.97 and 0.83; SMART-COP: 0.94, 0.29 and 0.77; SCAR 0.53, 0.95 and 0.81). CURB-65 had a lower discriminatory power compared to the other indices. Conclusions: PSI score and SCAP were more accurate and specific and SMART-COP was more sensitive to predict the risk of death. SMART-COP was more sensitive and SCAP was more specific in predicting the use of mechanical ventilation.
dc.format.extent9 páginas
dc.fuente.origenWOS
dc.identifier.eissn0717-6163
dc.identifier.issn0034-9887
dc.identifier.pubmedidMEDLINE:29171616
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/75696
dc.identifier.wosidWOS:000407985600002
dc.information.autorucMedicina;Canelo A;S/I;213515
dc.information.autorucMedicina;Diaz O;S/I;78564
dc.information.autorucMedicina;Gassmann J;S/I;234457
dc.information.autorucMedicina;Monasterio J;S/I;205690
dc.information.autorucMedicina;Saldias F;S/I;67197
dc.issue.numero6
dc.language.isoes
dc.nota.accesoSin adjunto
dc.pagina.final702
dc.pagina.inicio694
dc.publisherSOC MEDICA SANTIAGO
dc.revistaREVISTA MEDICA DE CHILE
dc.rightsregistro bibliográfico
dc.subjectMortality
dc.subjectPneumonia
dc.subjectPrognosis
dc.subjectSeverity of Illness Index
dc.subjectCLINICALLY RELEVANT OUTCOMES
dc.subjectSEVERITY ASSESSMENT TOOLS
dc.subjectECONOMIC BURDEN
dc.subjectMETAANALYSIS
dc.subjectVALIDATION
dc.subjectMORTALITY
dc.subjectADMISSION
dc.subjectSCORES
dc.subjectIMPACT
dc.subjectRULE
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAdverse event prediction in immunocompetent adult patients hospitalized with community-acquired pneumonia
dc.typeartículo
dc.volumen145
sipa.codpersvinculados213515
sipa.codpersvinculados78564
sipa.codpersvinculados234457
sipa.codpersvinculados205690
sipa.codpersvinculados67197
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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