Outcomes of community-acquired pneumonia using the Pneumonia Severity Index
Journal
ERJ open research
ISSN: 2312-0541
Titre abrégé: ERJ Open Res
Pays: England
ID NLM: 101671641
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
25
01
2023
accepted:
06
02
2023
medline:
5
5
2023
pubmed:
5
5
2023
entrez:
5
5
2023
Statut:
epublish
Résumé
The Pneumonia Severity Index (PSI) and the CURB-65 score assess disease severity in patients with community-acquired pneumonia (CAP). We compared the clinical performance of both prognostic scores according to clinical outcomes and admission rates. A nationwide retrospective cohort study was conducted using claims data from adult CAP patients presenting to the emergency department (ED) in 2018 and 2019. Dutch hospitals were divided into three categories: "CURB-65 hospitals" (n=25), "PSI hospitals" (n=19) and hospitals using both ("no-consensus hospitals", n=15). Main outcomes were hospital admission rates, intensive care unit admissions, length of hospital stay, delayed admissions, readmissions and all-cause 30-day mortality. Multilevel logistic and Poisson regression analysis were used to adjust for potential confounders. Of 50 984 included CAP patients, 21 157 were treated in CURB-65 hospitals, 17 279 in PSI hospitals and 12 548 in no-consensus hospitals. The 30-day mortality was significantly lower in CURB-65 hospitals In this study, using the CURB-65 in CAP patients at the ED is associated with similar and possibly even better clinical outcomes compared to using the PSI. After confirmation in prospective studies, the CURB-65 may be recommended over the use of the PSI since it is associated with lower 30-day mortality and is more user-friendly.
Sections du résumé
Background
UNASSIGNED
The Pneumonia Severity Index (PSI) and the CURB-65 score assess disease severity in patients with community-acquired pneumonia (CAP). We compared the clinical performance of both prognostic scores according to clinical outcomes and admission rates.
Methods
UNASSIGNED
A nationwide retrospective cohort study was conducted using claims data from adult CAP patients presenting to the emergency department (ED) in 2018 and 2019. Dutch hospitals were divided into three categories: "CURB-65 hospitals" (n=25), "PSI hospitals" (n=19) and hospitals using both ("no-consensus hospitals", n=15). Main outcomes were hospital admission rates, intensive care unit admissions, length of hospital stay, delayed admissions, readmissions and all-cause 30-day mortality. Multilevel logistic and Poisson regression analysis were used to adjust for potential confounders.
Findings
UNASSIGNED
Of 50 984 included CAP patients, 21 157 were treated in CURB-65 hospitals, 17 279 in PSI hospitals and 12 548 in no-consensus hospitals. The 30-day mortality was significantly lower in CURB-65 hospitals
Interpretation
UNASSIGNED
In this study, using the CURB-65 in CAP patients at the ED is associated with similar and possibly even better clinical outcomes compared to using the PSI. After confirmation in prospective studies, the CURB-65 may be recommended over the use of the PSI since it is associated with lower 30-day mortality and is more user-friendly.
Identifiants
pubmed: 37143846
doi: 10.1183/23120541.00051-2023
pii: 00051-2023
pmc: PMC10152258
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright ©The authors 2023.
Déclaration de conflit d'intérêts
Conflict of interest: W.J. Wiersinga reports two grants, the Vidi grant from the Dutch Research Council, and a grant on COVID-19 from The Netherlands Organisation for Health Research and Development. Furthermore, his host institution received ad hoc consultancy fees from GSK (DSMB), Pfizer, AstraZeneca and Sobi. All other authors report no conflicts of interest.
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