Validation of the qSOFA and CRB-65 in SARS-CoV-2-infected community-acquired pneumonia.
Journal
ERJ open research
ISSN: 2312-0541
Titre abrégé: ERJ Open Res
Pays: England
ID NLM: 101671641
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
15
03
2023
accepted:
05
04
2023
medline:
20
6
2023
pubmed:
20
6
2023
entrez:
20
6
2023
Statut:
epublish
Résumé
Prognostic accuracy of the quick sequential organ failure assessment (qSOFA) and CRB-65 (confusion, respiratory rate, blood pressure and age (≥65 years)) risk scores have not been widely evaluated in patients with SARS-CoV-2-positive compared to SARS-CoV-2-negative community-acquired pneumonia (CAP). The aim of the present study was to validate the qSOFA(-65) and CRB-65 scores in a large cohort of SARS-CoV-2-positive and SARS-CoV-2-negative CAP patients. We included all cases with CAP hospitalised in 2020 from the German nationwide mandatory quality assurance programme and compared cases with SARS-CoV-2 infection to cases without. We excluded cases with unclear SARS-CoV-2 infection state, transferred to another hospital or on mechanical ventilation during admission. Predefined outcomes were hospital mortality and need for mechanical ventilation. Among 68 594 SARS-CoV-2-positive patients, hospital mortality (22.7%) and mechanical ventilation (14.9%) were significantly higher when compared to 167 880 SARS-CoV-2-negative patients (15.7% and 9.2%, respectively). All CRB-65 and qSOFA criteria were associated with both outcomes, and age dominated mortality prediction in SARS-CoV-2 (risk ratio >9). Scores including the age criterion had higher area under the curve (AUCs) for mortality in SARS-CoV-2-positive patients ( Hospital mortality and mechanical ventilation rates were higher in SARS-CoV-2-positive than SARS-CoV-2-negative CAP. For SARS-CoV-2-positive CAP, the CRB-65 and qSOFA-65 scores showed adequate prediction of mortality but not of mechanical ventilation.
Identifiants
pubmed: 37337510
doi: 10.1183/23120541.00168-2023
pii: 00168-2023
pmc: PMC10105511
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright ©The authors 2023.
Déclaration de conflit d'intérêts
Conflict of interest: The authors have nothing to disclose.
Références
Anaesthesist. 2021 Dec;70(Suppl 1):19-29
pubmed: 33245382
JAMA. 2016 Feb 23;315(8):801-10
pubmed: 26903338
Front Med (Lausanne). 2022 Mar 02;9:779516
pubmed: 35308539
Semin Respir Crit Care Med. 2016 Dec;37(6):886-896
pubmed: 27960212
Pneumologie. 2016 Mar;70(3):151-200
pubmed: 26926396
BMJ Open Respir Res. 2022 Aug;9(1):
pubmed: 36002181
Curr Med Res Opin. 2020 Nov;36(11):1747-1752
pubmed: 32986475
BMJ. 2020 Sep 9;370:m3339
pubmed: 32907855
Lancet Respir Med. 2021 Apr;9(4):349-359
pubmed: 33444539
Ann Emerg Med. 2020 Oct;76(4):442-453
pubmed: 33012378
Thorax. 2003 May;58(5):377-82
pubmed: 12728155
Thorax. 2012 Jan;67(1):71-9
pubmed: 20729232
Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67
pubmed: 31573350
Respir Med. 2016 Dec;121:32-38
pubmed: 27888989
Thorax. 2009 Dec;64(12):1062-9
pubmed: 19454409
Intern Emerg Med. 2019 Jun;14(4):603-615
pubmed: 30725323
BMJ. 2020 Apr 7;369:m1328
pubmed: 32265220
Clin Microbiol Infect. 2021 Sep;27(9):1345.e1-1345.e6
pubmed: 33049414
Pulmonology. 2019 Mar - Apr;25(2):66-70
pubmed: 30026065
Medicine (Baltimore). 2018 Oct;97(40):e12634
pubmed: 30290639
J Gen Intern Med. 2021 May;36(5):1338-1345
pubmed: 33575909
Intensive Care Med. 2021 Dec;47(12):1426-1439
pubmed: 34585270
Eur Respir J. 2020 Dec 24;56(6):
pubmed: 32978307
Chest. 2022 Oct;162(4):768-781
pubmed: 35609674
Eur Respir J. 2022 Aug 10;60(2):
pubmed: 35710264
Intensive Care Med. 2016 Dec;42(12):2108-2110
pubmed: 27647332
Int J Infect Dis. 2022 Feb;115:39-47
pubmed: 34800689
Lancet Respir Med. 2020 Sep;8(9):853-862
pubmed: 32735842
Emerg Med J. 2021 Aug;38(8):587-593
pubmed: 34083427