scholarly journals The CURB65 pneumonia severity score outperforms generic sepsis and early warning scores in predicting mortality in community-acquired pneumonia

Thorax ◽  
2007 ◽  
Vol 62 (3) ◽  
pp. 253-259 ◽  
Author(s):  
G. Barlow ◽  
D. Nathwani ◽  
P. Davey
Keyword(s):  
Early Warning ◽  
Severity Score ◽  
Community Acquired Pneumonia ◽  
Pneumonia Severity ◽  
Early Warning Scores

scholarly journals Expanded CURB-65: a new score system predicts severity of community-acquired pneumonia with superior efficiency

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Jin-liang Liu ◽  
Feng Xu ◽  
Hui Zhou ◽  
Xue-jie Wu ◽  
Ling-xian Shi ◽  
...  
Keyword(s):  
Severity Score ◽  
Community Acquired Pneumonia ◽  
Score System ◽  
Pneumonia Severity ◽  
Increased Risk ◽  
Severity Scores ◽  
Low Blood Pressure ◽  
Health Care Associated Pneumonia ◽  
Score Systems ◽  
Better Than

Abstract Aim of this study was to develop a new simpler and more effective severity score for community-acquired pneumonia (CAP) patients. A total of 1640 consecutive hospitalized CAP patients in Second Affiliated Hospital of Zhejiang University were included. The effectiveness of different pneumonia severity scores to predict mortality was compared, and the performance of the new score was validated on an external cohort of 1164 patients with pneumonia admitted to a teaching hospital in Italy. Using age ≥ 65 years, LDH > 230 u/L, albumin < 3.5 g/dL, platelet count < 100 × 109/L, confusion, urea > 7 mmol/L, respiratory rate ≥ 30/min, low blood pressure, we assembled a new severity score named as expanded-CURB-65. The 30-day mortality and length of stay were increased along with increased risk score. The AUCs in the prediction of 30-day mortality in the main cohort were 0.826 (95% CI, 0.807–0.844), 0.801 (95% CI, 0.781–0.820), 0.756 (95% CI, 0.735–0.777), 0.793 (95% CI, 0.773–0.813) and 0.759 (95% CI, 0.737–0.779) for the expanded-CURB-65, PSI, CURB-65, SMART-COP and A-DROP, respectively. The performance of this bedside score was confirmed in CAP patients of the validation cohort although calibration was not successful in patients with health care-associated pneumonia (HCAP). The expanded CURB-65 is objective, simpler and more accurate scoring system for evaluation of CAP severity, and the predictive efficiency was better than other score systems.

scholarly journals Early identification of severe community-acquired pneumonia: a retrospective observational study

2019 ◽  
Vol 6 (1) ◽  
pp. e000438 ◽  
Author(s):  
Frances S Grudzinska ◽  
Kerrie Aldridge ◽  
Sian Hughes ◽  
Peter Nightingale ◽  
Dhruv Parekh ◽  
...  
Keyword(s):  
Early Warning ◽  
Assessment Tool ◽  
Characteristic Curve ◽  
Community Acquired Pneumonia ◽  
Adverse Outcomes ◽  
Assessment Tools ◽  
Early Warning Score ◽  
News Medium ◽  
Increased Risk ◽  
Early Warning Scores

BackgroundCommunity-acquired pneumonia (CAP) is a leading cause of sepsis worldwide. Prompt identification of those at high risk of adverse outcomes improves survival by enabling early escalation of care. There are multiple severity assessment tools recommended for risk stratification; however, there is no consensus as to which tool should be used for those with CAP. We sought to assess whether pneumonia-specific, generic sepsis or early warning scores were most accurate at predicting adverse outcomes.MethodsWe performed a retrospective analysis of all cases of CAP admitted to a large, adult tertiary hospital in the UK between October 2014 and January 2016. All cases of CAP were eligible for inclusion and were reviewed by a senior respiratory physician to confirm the diagnosis. The association between the CURB65, Lac-CURB-65, quick Sequential (Sepsis-related) Organ Failure Assessment tool (qSOFA) score and National Early Warning Score (NEWS) at the time of admission and outcome measures including intensive care admission, length of hospital stay, in-hospital, 30-day, 90-day and 365-day all-cause mortality was assessed.Results1545 cases were included with 30-day mortality of 19%. Increasing score was significantly associated with increased risk of poor outcomes for all four tools. Overall accuracy assessed by receiver operating characteristic curve analysis was significantly greater for the CURB65 and Lac-CURB-65 scores than qSOFA. At admission, a CURB65 ≥2, Lac-CURB-65 ≥moderate, qSOFA ≥2 and NEWS ≥medium identified 85.0%, 96.4%, 40.3% and 79.0% of those who died within 30 days, respectively. A Lac-CURB-65 ≥moderate had the highest negative predictive value: 95.6%.ConclusionAll four scoring systems can stratify according to increasing risk in CAP; however, when a confident diagnosis of pneumonia can be made, these data support the use of pneumonia-specific tools rather than generic sepsis or early warning scores.

scholarly journals Evaluation of severity score-guided approaches to macrolide use in community-acquired pneumonia

2017 ◽  
Vol 50 (3) ◽  
pp. 1602306 ◽  
Author(s):  
Aran Singanayagam ◽  
Stefano Aliberti ◽  
Catia Cillóniz ◽  
Antoni Torres ◽  
Francesco Blasi ◽  
...  
Keyword(s):  
Severity Score ◽  
Community Acquired Pneumonia

scholarly journals National Early Warning Scores And COVID-19 Deaths In Care Homes: An Ecological Time Series Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 962-963
Author(s):  
Daniel Stow ◽  
Robert Barker ◽  
Fiona Matthews ◽  
Barbara Hanratty
Keyword(s):  
Time Series ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Early Warning ◽  
Disease Surveillance ◽  
Care Home ◽  
Outcome Data ◽  
Care Homes ◽  
Individual Level ◽  
Early Warning Scores

Abstract Tracking COVID-19 infections in the care home population has been challenging, because of the limited availability of testing and varied disease presentation. We consider whether National Early Warning Scores (NEWS/NEWS2) could contribute to COVID-19 surveillance in care homes. We analysed NEWS measurements from care homes in England (December 2019 to May 2020). We estimated pre-COVID (baseline) levels for NEWS and NEWS components using 80th and 20th centile scores for measurements before March 2020. We used time-series to compare the proportion of above-baseline NEWS to area-matched reports of registered deaths in care home residents from the Office for National Statistics We analysed 29,656 anonymised NEWS from 6,464 people in 480 care home units across 46 local authority areas. From March 23rd to May 20th, there were 5,753 deaths (1,532 involving COVID-19, 4,221 other causes) in corresponding geographical areas. A rise in the proportion of above-baseline NEWS was observed from March 16th 2020. The proportion of above-baseline oxygen saturation, respiratory rate and temperature measurements also increased approximately two weeks before peaks in deaths. We conclude that NEWS could contribute to disease surveillance in care homes during the COVID-19 pandemic. Oxygen saturation, respiratory rate and temperature could be prioritised as they appear to signal rise in mortality almost as well as total NEWS. This study reinforces the need to collate data from care homes, to monitor and protect residents’ health. Further work using individual level outcome data is needed to evaluate the role of NEWS in the early detection of resident illness.

Soluble form of suppression of tumorigenicity-2 predicts clinical stability of inpatients with community-acquired pneumonia

2021 ◽  
pp. 153537022110271
Author(s):  
Yifeng Zeng ◽  
Mingshan Xue ◽  
Teng Zhang ◽  
Shixue Sun ◽  
Runpei Lin ◽  
...  
Keyword(s):  
Regression Model ◽  
Predictive Value ◽  
Cox Regression ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Risk Classification ◽  
Soluble Form ◽  
Pneumonia Severity ◽  
Clinical Stability

The soluble form of the suppression of tumorigenicity-2 (sST2) is a biomarker for risk classification and prognosis of heart failure, and its production and secretion in the alveolar epithelium are significantly correlated with the inflammation-inducing in pulmonary diseases. However, the predictive value of sST2 in pulmonary disease had not been widely studied. This study investigated the potential value in prognosis and risk classification of sST2 in patients with community-acquired pneumonia. Clinical data of ninety-three CAP inpatients were retrieved and their sST2 and other clinical indices were studied. Cox regression models were constructed to probe the sST2’s predictive value for patients’ restoring clinical stability and its additive effect on pneumonia severity index and CURB-65 scores. Patients who did not reach clinical stability within the defined time (30 days from hospitalization) have had significantly higher levels of sST2 at admission ( P <  0.05). In univariate and multivariate Cox regression analysis, a high sST2 level (≥72.8 ng/mL) was an independent reverse predictor of clinical stability ( P < 0.05). The Cox regression model combined with sST2 and CURB-65 (AUC: 0.96) provided a more accurate risk classification than CURB-65 (AUC:0.89) alone (NRI: 1.18, IDI: 0.16, P < 0.05). The Cox regression model combined with sST2 and pneumonia severity index (AUC: 0.96) also provided a more accurate risk classification than pneumonia severity index (AUC:0.93) alone (NRI: 0.06; IDI: 0.06, P < 0.05). sST2 at admission can be used as an independent early prognostic indicator for CAP patients. Moreover, it can improve the predictive power of CURB-65 and pneumonia severity index score.

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