The value of prognostic indices for pneumonia

Abstract

One of the most important decisions in the management of community-acquired pneumonia is deciding the care site, which affects morbidity, mortality, and costs. Clinical judgment alone is difficult and imprecise. The Pneumonia Severity Index score and the CURB-65 (confusion, urea nitrogen, respiratory rate, blood pressure, 65 years of age and older) score are validated prognostic indices to predict mortality, and they can identify low-risk patients who may be eligible for outpatient management. However, limitations of the scoring systems preclude their isolated use, and they can only be recommended as an aid to guide hospital admission decisions. The Pneumonia Severity Index score is slightly better at identifying the lowest risk patients, whereas CURB-65 is much simpler to use. As an adjunct to clinical judgment, we consider CURB-65 to be the most useful prognostic index for identifying low-risk patients.

Death risk stratification in elderly patients with covid-19. A comparative cohort study in nursing homes outbreaks

“…In present days, CURB-65 index is probably the most used prognostic tool in patients with pneumonia ( Johnstone, Majumdar, & Marrie, 2008 ; Loke, Kwok, Niruban, & Myint, 2010 ; Man et al, 2011 ; Myint et al, 2009 ). Its accuracy in many different populations in addition with its easier and simpler calculation with respect to others, explain this fact ( Johnstone et al, 2008 ; Loke et al, 2010 ; Man et al, 2011 ; Myint et al, 2009 ). In the present study we obtained a similar accuracy as previously described ( Johnstone et al, 2008 ; Loke et al, 2010 ; Man et al, 2011 ; Myint et al, 2009 ).…”

Population-based cohort study of outpatients with pneumonia: rationale, design and baseline characteristics

“…Furthermore, data collection was necessarily (and by design) not so exhaustive as for inpatients [19,21]. The well-validated pneumonia severity index [PSI] was calculated on all patients at time of presentation [16,22]. For patients with a PSI score >90, or if requested by emergency department physician, an inpatient physician was consulted for admission to hospital.…”

Health promotion, risk stratification, and treatment options to decrease hospitalization rates for community-acquired pneumonia in adults

“…Determination of hospitalization for CAP is difficult with the multiple factors both clinical and social that must be considered. There is an increased risk of mortality associated with “respiratory rates greater than 30, diastolic hypotension, and an elevated blood urea nitrogen level” (Johnstone, Majumdar, & Marrie, , p. 215). Risk estimates vary widely by providers and it is thought that variations and systemic overestimates of mortality affect hospital admission rates despite CAP incidence (Johnstone et al., ).…”