This article is more than 5 years old. Information may no longer be current.
Scoring system used for CAP also effective for health care-associated pneumonia
Prognostic scoring systems used for community-acquired pneumonia were comparable when used for patients with health care-associated pneumonia, researchers from Sungkyunkwan University of Medicine in Seoul, Republic of Korea, have found.
“Compared with community-acquired pneumonia (CAP), health care-associated pneumonia is a distinct type of pneumonia with unique microbiological and epidemiological characteristics and outcomes,” the researchers wrote in Clinical Infectious Diseases. “Nevertheless, pneumonia scoring index (PSI) and the combination of confusion, urea, respiratory rate, blood pressure and age 65 and older (CURB-65) have been used to assess the severity of illness in patients with health care-associated pneumonia, although there are few studies validating these scoring systems in these patients.”
The researchers conducted a retrospective, observational study using prospective data to evaluate the performance of PSI and CURB-65 in patients with health care-associated pneumonia. The study included 938 patients with pneumonia: 519 had CAP and 419 had health care-associated pneumonia.
In both groups, worsening PSI and CURB-65 scores were related to increasing mortality. Overall, mortality was higher among the health care-associated pneumonia group. In the CAP group, low-risk patients based on PSI and CURB-65 scores had low aggregate 30-day mortality. In the health care-associated pneumonia group, low-risk patients according to CURB-65 scores had a higher aggregate 30-day mortality compared with low-risk patients according to PSI. In both groups, PSI had a higher sensitivity but lower specificity than CURB-65.
“The discriminatory powers of PSI and CURB-65 for 30-day mortality were significantly low in patients with health care-associated pneumonia compared to those in patients with community-acquired pneumonia,” the researchers wrote. “Therefore, future studies are needed to define: more accurate scores to predict outcome of patients with health care-associated pneumonia.”
Disclosure: The researchers report no relevant financial disclosures.