Chest Infections |

Development of Severity Index for Nursing Home Pneumonia FREE TO VIEW

Jae Ho Chung, MD; Chang Hoon Han, MD
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Kwandong University Hospital, Incheon, Republic of Korea

Chest. 2013;144(4_MeetingAbstracts):257A. doi:10.1378/chest.1668127
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SESSION TITLE: Infections in Older Patients

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 27, 2013 at 04:15 PM - 05:15 PM

PURPOSE: To compare current scoring indices (NHAP model score, PSI, CURB-65, and SOAR) in their prediction of mortality and ICU admission in patients with nursing home acquired pneumonia

METHODS: This retrospective observational study was conducted between July 2008 and June 2011 using data from the Korean Nursing Home Networks. Two hundred and eight nursing home residents were hospitalized with pneumonia in one general hospital. The primary outcome measure was 30 day all-cause mortality. Secondary outcome measures were intensive respiratory or vasopressor support (IRVS) and severe pneumonia (ICU admission or IRVS).

RESULTS: PSI class V showed the highest specificity (66.7%), positive predictable value (PPV, 40.0%), negative predictable value (NPV, 91.5%) and area under curve (AUC, 0.73) of 30-day mortality. Concerning severe pneumonia, PSI class V showed the highest specificity (72.8%), PPV (62.2%), NPV (77.1%), and AUC (0.70). Similarly, PSI class V showed the highest specificity (68.3%), PPV (51.1%), NPV (80.5%), and AUC (0.69) of IRVS.

CONCLUSIONS: PSI has superior discriminatory power in predicting all three clinical outcomes (30-day mortality, severe pneumonia, and IVRS) compared with NHAP model score , CURB65 and SOAR

CLINICAL IMPLICATIONS: This study may be useful for nursing home pneumonia severity index.

DISCLOSURE: The following authors have nothing to disclose: Jae Ho Chung, Chang Hoon Han

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