Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad

Background: Community-acquired pneumonia (CAP) causes significant morbidity and mortality in adults. Aim: To compare the accuracy of four validated rules for predicting adverse outcomes in patients hospitalized with CAP. Patients and Methods: We compared the pneumonia severity index (PSI), Britis...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Saldías Peñafiel,Fernando, Uribe Monasterio,Javier, Gassmann Poniachik,Javiera, Canelo López,Alejandro, Díaz Patiño,Orlando
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2017
Materias:	Mortality Pneumonia Prognosis Severity of Illness Index
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000600694
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:scielo:S0034-98872017000600694
record_format	dspace
spelling	oai:scielo:S0034-988720170006006942017-11-17Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidadSaldías Peñafiel,FernandoUribe Monasterio,JavierGassmann Poniachik,JavieraCanelo López,AlejandroDíaz Patiño,Orlando Mortality Pneumonia Prognosis Severity of Illness Index Background: Community-acquired pneumonia (CAP) causes significant morbidity and mortality in adults. Aim: To compare the accuracy of four validated rules for predicting adverse outcomes in patients hospitalized with CAP. Patients and Methods: We compared the pneumonia severity index (PSI), British Thoracic Society score (CURB-65), SMART-COP and severe CAP score (SCAP) in 659 immunocompetent adult patients aged 18 to 101 years, 52% male, hospitalized with CAP. Major adverse outcomes were: admission to ICU, need for mechanical ventilation (MV), in-hospital complications and 30-day mortality. Mean hospital length of stay (LOS) was also evaluated. The predictive indexes were compared based on sensitivity, specificity, and area under the curve of the receiver operating characteristic curve. Results: Of the studied patients, 77% had comorbidities, 23% were admitted to the intensive care unit and 12% needed mechanical ventilation. The rate of all adverse outcomes and hospital LOS increased directly with increasing PSI, CURB-65, SMART-COP and SCAP scores. The sensitivity, specificity and area under the curve of the prognostic indexes to predict adverse events were: Admission to ICU (PSI: 0.48, 0.84 and 0.73; SMART-COP: 0.97, 0.23 and 0.75; SCAP: 0.57, 0.81 and 0.76); use of MV (PSI: 0.44, 0.84 and 0.75; SMART-COP: 0.96, 0.35 and 0.84; SCAP: 0.53, 0.87 and 0.78); 30-days mortality (PSI: 0.45, 0.97 and 0.83; SMART-COP: 0.94, 0.29 and 0.77; SCAP: 0.53, 0.95 and 0.81). CURB-65 had a lower discriminatory power compared to the other indices. Conclusions: PSI score and SCAP were more accurate and specific and SMART-COP was more sensitive to predict the risk of death. SMART-COP was more sensitive and SCAP was more specific in predicting the use of mechanical ventilation.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.145 n.6 20172017-06-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000600694es10.4067/s0034-98872017000600694
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Mortality Pneumonia Prognosis Severity of Illness Index
spellingShingle	Mortality Pneumonia Prognosis Severity of Illness Index Saldías Peñafiel,Fernando Uribe Monasterio,Javier Gassmann Poniachik,Javiera Canelo López,Alejandro Díaz Patiño,Orlando Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad
description	Background: Community-acquired pneumonia (CAP) causes significant morbidity and mortality in adults. Aim: To compare the accuracy of four validated rules for predicting adverse outcomes in patients hospitalized with CAP. Patients and Methods: We compared the pneumonia severity index (PSI), British Thoracic Society score (CURB-65), SMART-COP and severe CAP score (SCAP) in 659 immunocompetent adult patients aged 18 to 101 years, 52% male, hospitalized with CAP. Major adverse outcomes were: admission to ICU, need for mechanical ventilation (MV), in-hospital complications and 30-day mortality. Mean hospital length of stay (LOS) was also evaluated. The predictive indexes were compared based on sensitivity, specificity, and area under the curve of the receiver operating characteristic curve. Results: Of the studied patients, 77% had comorbidities, 23% were admitted to the intensive care unit and 12% needed mechanical ventilation. The rate of all adverse outcomes and hospital LOS increased directly with increasing PSI, CURB-65, SMART-COP and SCAP scores. The sensitivity, specificity and area under the curve of the prognostic indexes to predict adverse events were: Admission to ICU (PSI: 0.48, 0.84 and 0.73; SMART-COP: 0.97, 0.23 and 0.75; SCAP: 0.57, 0.81 and 0.76); use of MV (PSI: 0.44, 0.84 and 0.75; SMART-COP: 0.96, 0.35 and 0.84; SCAP: 0.53, 0.87 and 0.78); 30-days mortality (PSI: 0.45, 0.97 and 0.83; SMART-COP: 0.94, 0.29 and 0.77; SCAP: 0.53, 0.95 and 0.81). CURB-65 had a lower discriminatory power compared to the other indices. Conclusions: PSI score and SCAP were more accurate and specific and SMART-COP was more sensitive to predict the risk of death. SMART-COP was more sensitive and SCAP was more specific in predicting the use of mechanical ventilation.
author	Saldías Peñafiel,Fernando Uribe Monasterio,Javier Gassmann Poniachik,Javiera Canelo López,Alejandro Díaz Patiño,Orlando
author_facet	Saldías Peñafiel,Fernando Uribe Monasterio,Javier Gassmann Poniachik,Javiera Canelo López,Alejandro Díaz Patiño,Orlando
author_sort	Saldías Peñafiel,Fernando
title	Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad
title_short	Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad
title_full	Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad
title_fullStr	Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad
title_full_unstemmed	Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad
title_sort	evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad
publisher	Sociedad Médica de Santiago
publishDate	2017
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000600694
work_keys_str_mv	AT saldiaspenafielfernando evaluaciondelosindicespredictoresdeeventosadversoseneladultoinmunocompetentehospitalizadoporneumoniaadquiridaenlacomunidad AT uribemonasteriojavier evaluaciondelosindicespredictoresdeeventosadversoseneladultoinmunocompetentehospitalizadoporneumoniaadquiridaenlacomunidad AT gassmannponiachikjaviera evaluaciondelosindicespredictoresdeeventosadversoseneladultoinmunocompetentehospitalizadoporneumoniaadquiridaenlacomunidad AT canelolopezalejandro evaluaciondelosindicespredictoresdeeventosadversoseneladultoinmunocompetentehospitalizadoporneumoniaadquiridaenlacomunidad AT diazpatinoorlando evaluaciondelosindicespredictoresdeeventosadversoseneladultoinmunocompetentehospitalizadoporneumoniaadquiridaenlacomunidad
_version_	1718436947706249216

Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad

Ejemplares similares