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Abstract: Poster Presentations |

COMPARISON OF THE TWO SCORING INDICES (CURB65 AND PSI) AND DETERMINATION OF THEIR UTILITY IN PREDICTING THE SEVERITY OF COMMUNITY-ACQUIRED PNEUMONIA AMONG PATIENTS BOTH ADMITTED AND TREATED AS OUTPATIENTS FREE TO VIEW

Mitzi Y. Banate, MD*; Aileen G. Banzon, MD; Teresita S. De Guia, MD; Fernando G. Ayuyao, MD
Author and Funding Information

Pulmonary Medicine Philippine Heart Center, Quezon City, Philippines


Chest


Chest. 2009;136(4_MeetingAbstracts):52S. doi:10.1378/chest.136.4_MeetingAbstracts.52S-b
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Abstract

PURPOSE:  The purpose of this study is to help the clinician in determining which scoring index can best assess severity of pneumonia in order to help in the management and subsequent outcomes.

METHODS:  Clinical and demographic data of each patient was recorded. For patients seen and treated as outpatients, follow up after 3–5 days of hospital visit is compelled. Subsequent hospital admissions due to pneumonia-related complications and vital status with in 4 weeks will be recorded. Patients discharged with in 4 weeks of hospital visits will be included in the inpatient group. For admitted patients, the following will be recorded: a.) total duration of hospital stay, b.) vital status after discharge with in 4 weeks, c.) admission to the ICU and use of mechanical ventilator, and d) hospital re-admission with in 4 weeks due to pneumonia-related complication.

RESULTS:  A total of 97 adult patients (male-41 and female-56) with a diagnosis of community acquired pneumonia seen in the emergency department in a 302-bed teaching hospital were evaluated basing on the CURB65and PSI score. Of the ninety seven patients that were admitted, 31 of whom (31.9%) required ICU admission. The mean age is 73 ± 16.42 9 (SD). Both CURB65 and PSI showed significant results in predicting the outcome of CAP with a p value of 0.000. However, CURB65 found to have a better discriminatory result compared to PSI. A score of ≥ 3 for CURB65 and 5 for PSI are the most sensitive cut off value with a kappa coefficient Of 0.56 ± 0.09 (p value-0.000) and 0.50 ± 0.09 (p value-0.00), respectively. In this study, we found that CURB65 showed the slightly better sensitivity and specificity (91.7% and 85.9%) in predicting the severity CAP as compared to PSI (100% and 47.1%).

CONCLUSION:  In conclusion, CURB 65 has slightly better discriminating power in predicting 30-day mortality as compared to PSI.

CLINICAL IMPLICATIONS:  This study will guide and help the clinician in determining the severity of community acquired pneumonia.

DISCLOSURE:  Mitzi Banate, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

12:45 PM - 2:00 PM


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