2016年3月8日
A mortality prediction rule for non-elderly patients with community-acquired pneumonia.
BMC pulmonary medicine
- 巻
- 16
- 号
- 開始ページ
- 39
- 終了ページ
- 39
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1186/s12890-016-0199-z
- 出版者・発行元
- BIOMED CENTRAL LTD
Background: No mortality prediction rule is suited for non-elderly patients with community-acquired pneumonia. Therefore, we tried to create a mortality prediction rule that is simple and suitable for non-elderly patients with community-acquired pneumonia.
Methods: Because of low mortality at young age, we used information from an administrative database that included A-DROP data. We analysed the rate and risk factors for in-hospital community-acquired pneumonia-associated death among non-elderly patients and created a mortality prediction rule based on those risk factors.
Results: We examined 49,370 hospitalisations for patients aged 18-64 years with community-acquired pneumonia. The 30-day fatality rate was 1.5 %. Using regression analysis, five risk factors were selected: patient requires help for feeding, the existence of malignancy, confusion, low blood pressure, and age 40-64 years. Each risk factor of our proposed mortality risk scoring system received one point. A total point score for each patient was obtained by summing the points. The negative likelihood ratio for the score 0 group was 0.01, and the positive likelihood ratio for the score >= 4 group was 19.9. The area under the curve of the risk score for non-elderly (0.86, 95 % confidence interval: 0.84-0.87) was higher than that of the A-DROP score (0.72, 95 % confidence interval: 0.70-0.74) (P < 0.0001).
Conclusions: Our newly proposed mortality risk scoring system may be appropriate for predicting mortality in non-elderly patients with community-acquired pneumonia. It showed a possibility of a better prediction value than the A-DROP and is easy to use in various clinical settings.
Methods: Because of low mortality at young age, we used information from an administrative database that included A-DROP data. We analysed the rate and risk factors for in-hospital community-acquired pneumonia-associated death among non-elderly patients and created a mortality prediction rule based on those risk factors.
Results: We examined 49,370 hospitalisations for patients aged 18-64 years with community-acquired pneumonia. The 30-day fatality rate was 1.5 %. Using regression analysis, five risk factors were selected: patient requires help for feeding, the existence of malignancy, confusion, low blood pressure, and age 40-64 years. Each risk factor of our proposed mortality risk scoring system received one point. A total point score for each patient was obtained by summing the points. The negative likelihood ratio for the score 0 group was 0.01, and the positive likelihood ratio for the score >= 4 group was 19.9. The area under the curve of the risk score for non-elderly (0.86, 95 % confidence interval: 0.84-0.87) was higher than that of the A-DROP score (0.72, 95 % confidence interval: 0.70-0.74) (P < 0.0001).
Conclusions: Our newly proposed mortality risk scoring system may be appropriate for predicting mortality in non-elderly patients with community-acquired pneumonia. It showed a possibility of a better prediction value than the A-DROP and is easy to use in various clinical settings.
- リンク情報
-
- DOI
- https://doi.org/10.1186/s12890-016-0199-z
- PubMed
- https://www.ncbi.nlm.nih.gov/pubmed/26956147
- PubMed Central
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4784337
- Web of Science
- https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000371978300001&DestApp=WOS_CPL
- ID情報
-
- DOI : 10.1186/s12890-016-0199-z
- ISSN : 1471-2466
- PubMed ID : 26956147
- PubMed Central 記事ID : PMC4784337
- Web of Science ID : WOS:000371978300001