CURB-65 and other markers of illness severity in community-acquired pneumonia among HIV-positive patients

Almeida, André; Almeida, Ana Rita; Vesza, Zsófia; Pereira, Rui

doi:10.1177/0956462415605232

Cited by 12 publications

(9 citation statements)

References 25 publications

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“…The PSI score of the patient was an independent predictor of mortality but CURB_65 was not a good predictor of mortality. 15,16 In conclusion, the early prediction of the mortality risk is important to determine the high risk patients to hospitalize in intensive care unit and close follow up. But when we look at the mortality rates in each CURB_65 score, the mortality rates are increasing while CURB_65 score is increasing ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…14 Also some other studies reported that the higher the CURB_65 score the higher the mortality. 15,16 In conclusion, the early prediction of the mortality risk is important to determine the high risk patients to hospitalize in intensive care unit and close follow up. The lactate level, PSI score and CURB_65 scores are good predictors for mortality.…”

Section: Figu Re 1 Roc Curve Of Lactate Level For Mortalitymentioning

confidence: 99%

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Lactate levels and pneumonia severity index are good predictors of in‐hospital mortality in pneumonia

Demirel¹

2017

Clinical Respiratory J

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Introduction: Pneumonia is an inflammatory disease caused by micro-organisms. The pneumonia severity index (PSI) and CURB_65 scores are widely used to predict the mortality risk. We wanted to calculate the value of lactic acid level in predicting the mortality risk. Materials and methods:This prospective cross-sectional study performed in a third level education and research hospital. The pneumonia diagnosis was determined by symptoms, physical examination findings, and radiological findings.Results: The mean age of the patients was 71.0 6 16.5. The overall mortality rate was 21.8%. The mean lactate level was 3.53 6 3.59. Lactate is significantly higher in patients who were died. The PSI and CURB_65 scores were higher in patients who died. The cutoff value of lactate level for mortality is 3.35 mmol/mm3. The cutoff point of PSI for mortality was 148.5 points; equal or over this point the mortality rate is 90.9%. Discussion:The early prediction of the mortality risk is important to determine the high risk patients to hospitalize in intensive care unit and close follow up. The lactate level, PSI score and CURB_65 scores are good predictors for mortality. We can use them in emergency departments for risk stratification. K E Y W O R D S CURB_65, lactate, mortality, pneumonia, pneumonia severity index Clin Respir J. 2018;12:991-995.wileyonlinelibrary.com/journal/crj

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Section: Discussionmentioning

confidence: 99%

Section: Figu Re 1 Roc Curve Of Lactate Level For Mortalitymentioning

confidence: 99%

Lactate levels and pneumonia severity index are good predictors of in‐hospital mortality in pneumonia

Demirel¹

2017

Clinical Respiratory J

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“…The study by Albrich et al (42), which analyzed the association between nasopharyngeal S. pneumoniae densities in HIV-infected patients from South Africa with markers of severity and poor outcomes, reported no correlation between CURB-65 and mortality in these patients. However, the study by Almeida et al (62) investigated the use of CURB65 in HIV-infected patients, and reported that a higher A c c e p t e d M a n u s c r i p t CURB65 score and a CD4 count lower than 200 cells/mL were both associated with worse outcomes. They concluded that the CURB65 score plus CD4 cell count could be used in HIV-infected patients with CAP.…”

Section: Assessment Of Severity and Making Site-of-care Decisionsmentioning

confidence: 99%

“…We recommend that such patients do not need treatment, admission, or care sites that differs from that of the general population. 13,14,15,17,18,19,20,22,23,24,25,27,28,29,30,62,63,66,67,68,70,71 A c c e p t e d M a n u s c r i p t…”

Section: Five-year Viewmentioning

confidence: 99%

Community-acquired bacterial pneumonia in adult HIV-infected patients

Cillóniz¹,

García-Vidal

Moreno

et al. 2018

Expert Review of Anti-infective Therapy

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Despite active antiretroviral therapy (ART), community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality among human immunodeficiency virus (HIV)-infected patients and incurs high health costs. Areas covered: This article reviews the most recent publications on bacterial CAP in the HIV-infected population, focusing on epidemiology, prognostic factors, microbial etiology, therapy, and prevention. The data discussed here were mainly obtained from a non-systematic review using Medline, and references from relevant articles. Expert commentary: HIV-infected patients are more susceptible to bacterial CAP. Although ART improves their immune response and has reduced CAP incidence, these patients continue to present increased risk of pneumonia in part because they show altered immunity and because immune activation persists. The risk of CAP in HIV-infected patients and the probability of polymicrobial or atypical infections are inversely associated with the CD4 cell count. Mortality in HIV-infected patients with CAP ranges from 6% to 15% but in well-controlled HIV-infected patients on ART the mortality is low and similar to that seen in HIV-negative individuals. Vaccination and smoking cessation are the two most important preventive strategies for bacterial CAP in well-controlled HIV-infected patients on ART.

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“…Similar findings were found by Almeida et al in 49 PLWH admitted with pneumonia in an emergency department with a median CRB65 score lower then HIV-negative patients but which were also associated with a higher risk of mortality. 37 In the paper of Yone et al, 54 out 62 PLWH admitted with community acquired pneumonia (CAP) had CRB65 of 0-1. 38 In our study, adding the pulse oximetry to CRB-65 score, as suggested by the Consensur II, the Latin America Pneumonia working Group, increased the ability to confidently predict the 30-day in-hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

Etiology, clinical, and epidemiological characteristics of severe respiratory infection in people living with HIV

et al. 2020

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People living with HIV (PLWH) are more prone to severe respiratory infections. We used the severe acute respiratory infection (SARI) definition to describe the etiology, clinical, and epidemiological characteristics in this population. This was a prospective observational study including PLWH hospitalized with fever and cough. Those with symptom onset up to 10 days were classified as severe acute respiratory infection and 11-30 days as non-severe acute respiratory infection. Blood, urine samples and nasopharyngeal swabs were collected. Data were extracted from patient charts during their hospital stay. Forty-nine patients were included, median CD4 cell count: 80 cells/mm 3 , median time since HIV diagnosis and hospital admission: 84 months and 80% were antiretroviral therapy exposed. Twenty-seven patients were classified as SARI. Etiology was identified in 69%, 47% were polymicrobial. Respiratory virus (9 SARI vs. 13 non-SARI), bacteria (5 SARI vs. 4 non-SARI), Mycobacterium tuberculosis (6 SARI group vs. 7 non-SARI group), Pneumocystis jirovecii (4 SARI vs. 1 non-SARI), Cryptococcus neoformans (1 SARI vs. 3 non-SARI), and influenza A (1 SARI vs. 2 non-SARI). Dyspnea was statistically more prevalent in SARI (78% vs. 36%, p ¼ 0.011) but the risk of death was higher in the non-SARI (4% vs. 36%, p ¼ 0.0067). In the severely immunocompromised PLWH, severe acute respiratory infection can be caused by multiple pathogens and codetection is a common feature.

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CURB-65 and other markers of illness severity in community-acquired pneumonia among HIV-positive patients

Cited by 12 publications

References 25 publications

Lactate levels and pneumonia severity index are good predictors of in‐hospital mortality in pneumonia

Lactate levels and pneumonia severity index are good predictors of in‐hospital mortality in pneumonia

Community-acquired bacterial pneumonia in adult HIV-infected patients

Etiology, clinical, and epidemiological characteristics of severe respiratory infection in people living with HIV

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