1. Development and validation of a new scoring system for prognostic prediction of community-acquired pneumonia in older adults
- Author
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Shirata, Masahiro, Ito, Isao, Ishida, Tadashi, Tachibana, Hiromasa, Tanabe, Naoya, Konishi, Satoshi, Oi, Issei, Hamao, Nobuyoshi, Nishioka, Kensuke, Matsumoto, Hisako, Yasutomo, Yoshiro, Kadowaki, Seizo, Ohnishi, Hisashi, Tomioka, Hiromi, Nishimura, Takashi, Hasegawa, Yoshinori, Nakagawa, Atsushi, and Hirai, Toyohiro
- Subjects
Aged, 80 and over ,Male ,Multidisciplinary ,Science ,Pneumonia ,Article ,Blood Urea Nitrogen ,Community-Acquired Infections ,Bedridden Persons ,Prognostic markers ,Humans ,Medicine ,Female ,Mortality ,Bacterial infection ,Confusion ,Hypoxia ,Serum Albumin ,Aged - Abstract
The discriminative power of CURB-65 for mortality in community-acquired pneumonia (CAP) is suspected to decrease with age. However, a useful prognostic prediction model for older patients with CAP has not been established. This study aimed to develop and validate a new scoring system for predicting mortality in older patients with CAP. We recruited two prospective cohorts including patients aged ≥ 65 years and hospitalized with CAP. In the derivation (n = 872) and validation cohorts (n = 1,158), the average age was 82.0 and 80.6 years and the 30-day mortality rate was 7.6% (n = 66) and 7.4% (n = 86), respectively. A new scoring system was developed based on factors associated with 30-day mortality, identified by multivariate analysis in the derivation cohort. This scoring system named CHUBA comprised five variables: confusion, hypoxemia (SpO2 ≤ 90% or PaO2 ≤ 60 mmHg), blood urea nitrogen ≥ 30 mg/dL, bedridden state, and serum albumin level ≤ 3.0 g/dL. With regard to 30-day mortality, the area under the receiver operating characteristic curve for CURB-65 and CHUBA was 0.672 (95% confidence interval, 0.607–0.732) and 0.809 (95% confidence interval, 0.751–0.856; P
- Published
- 2021