scholarly journals Prognostic values of pneumonia severity index, CURB-65 and expanded CURB-65 scores in community-acquired pneumonia in Zagazig University Hospitals

2017 ◽  
Vol 66 (3) ◽  
pp. 549-555 ◽  
Author(s):  
Samah M. Shehata ◽  
Ashraf E. Sileem ◽  
Noha E. Shahien
2021 ◽  
pp. 153537022110271
Author(s):  
Yifeng Zeng ◽  
Mingshan Xue ◽  
Teng Zhang ◽  
Shixue Sun ◽  
Runpei Lin ◽  
...  

The soluble form of the suppression of tumorigenicity-2 (sST2) is a biomarker for risk classification and prognosis of heart failure, and its production and secretion in the alveolar epithelium are significantly correlated with the inflammation-inducing in pulmonary diseases. However, the predictive value of sST2 in pulmonary disease had not been widely studied. This study investigated the potential value in prognosis and risk classification of sST2 in patients with community-acquired pneumonia. Clinical data of ninety-three CAP inpatients were retrieved and their sST2 and other clinical indices were studied. Cox regression models were constructed to probe the sST2’s predictive value for patients’ restoring clinical stability and its additive effect on pneumonia severity index and CURB-65 scores. Patients who did not reach clinical stability within the defined time (30 days from hospitalization) have had significantly higher levels of sST2 at admission ( P <  0.05). In univariate and multivariate Cox regression analysis, a high sST2 level (≥72.8 ng/mL) was an independent reverse predictor of clinical stability ( P < 0.05). The Cox regression model combined with sST2 and CURB-65 (AUC: 0.96) provided a more accurate risk classification than CURB-65 (AUC:0.89) alone (NRI: 1.18, IDI: 0.16, P < 0.05). The Cox regression model combined with sST2 and pneumonia severity index (AUC: 0.96) also provided a more accurate risk classification than pneumonia severity index (AUC:0.93) alone (NRI: 0.06; IDI: 0.06, P < 0.05). sST2 at admission can be used as an independent early prognostic indicator for CAP patients. Moreover, it can improve the predictive power of CURB-65 and pneumonia severity index score.


2002 ◽  
Vol 9 (4) ◽  
pp. 247-252 ◽  
Author(s):  
Mark C Fok ◽  
Zahra Kanji ◽  
Rajesh Mainra ◽  
Michael Boldt

BACKGROUND: Patients admitted to Lions Gate Hospital, North Vancouver, British Columbia, with a primary diagnosis of community-acquired pneumonia (CAP) have a mean length of stay (LOS) of 9.1 days compared with 7.9 days for peer group hospitals. This difference of 1.2 days results in an annual potential savings of 406 bed days and warranted an investigation into the management of CAP.OBJECTIVE: To characterize and provide recommendations for the management of CAP.METHODS: A retrospective chart review of patients admitted with a primary diagnosis of CAP between May 1, 2000 and August 31, 2000.RESULTS: Fifty-one patients were included in the study, with a mean LOS of 9.9 days and a median LOS of five days. Based on pneumonia severity index scores calculated for each patient, eight patients (16%) were admitted inappropriately. Initial empirical antibiotic choices were consistent with the Canadian CAP guidelines in 27 patients (53%), with inconsistencies arising mainly because cephalosporin or azithromycin monotherapy regimens were prescribed. Step-down from intravenous to oral antibiotics occurred in approximately 20 patients (39%). An additional 12 patients (24%) could have undergone step-down, and step-down was not applicable in 19 patients (37%). The potential annual cost avoidance from implementing admission criteria based on a pneumonia severity index score, applying step-down criteria and promoting early discharge criteria was estimated to be $220,000.CONCLUSIONS: Considerable variability exists in the treatment of CAP. A CAP preprinted order sheet was developed to address the issues identified in the present study and provide consistency in the management of CAP at Lions Gate Hospital.


CHEST Journal ◽  
2007 ◽  
Vol 132 (4) ◽  
pp. 559A ◽  
Author(s):  
Guy Richards ◽  
Howard Levy ◽  
Pierre-Francois Laterre ◽  
Charles Feldman ◽  
Becky M. Bates ◽  
...  

2019 ◽  
Vol 7 (7) ◽  
pp. 360-369
Author(s):  
Fatma Tokgoz Akyil ◽  
Sumeyye Alparslan Bekir ◽  
Aylin Gungor ◽  
Kubra Akyuz ◽  
Neslihan Kose ◽  
...  

Background A considerable percentage of empirical antibiotic treatment fails in hospitalized patients with community-acquired pneumonia (CAP). β-lactams and macrolid (BLM) combination or respiratory fluoroquinolones (FQ) are the most frequently used in these patients. The aim of the present study is to compare the treatment failure (TF) rates in BLM and FQ treatment and to analyze the predictive factors of TF. Method Hospitalized patients who were initially treated with either BLM or FQ were included retrospectively and treatment results of the two regimens were compared. Results Of the 144 patients included in the study, the mean age was 67±16 and 102 (71%) were male. Each group constituted of 72 patients. Antibiotic selection did not alter TF rates, length of stay (LOS) and 30-day mortality. Baseline higher levels of leucocytes, neutrophils to lymphocytes ratio (NLR), C-reactive protein (CRP), BUN/albumin, lactate dehydrogenase/aspartat aminotransferase (LDH/AST) levels and pneumonia severity index (PSI) scores were detected as predictors of TF. Conclusion Empirical treatments with either BLM or FQ do not correlate with TF, LOS and 30-day mortality. NLR, BUN/albumin and LDH/AST may suggest TF. These inexpensive and easily-reachable parameters have the potential as predictors of the treatment outcome in CAP.   Notices of retraction Akyil, F. T., Bekir, S. A., Gungor, A., Akyuz, K., Kose, N., Turker, H., Akyil, M., & Sevim, T. (2019). TREATMENT FAILURE AND EMPIRIC ANTIBIOTIC CHOICE FOR HOSPITALIZED PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: Β-LACTAM/Β-LACTAMASE INHIBITOR COMBINED WITH MACROLID OR FLUOROQUINOLONE ALONE?. International Journal of Research -GRANTHAALAYAH, 7(7), 360-369. https://doi.org/10.29121/granthaalayah.v7.i7.2019.778 Article retracted by : EditorReason(s) for retraction : Author's conflicts of interest


Author(s):  
Hiba Mayya ◽  
Malek Hejazie ◽  
Youssef Zreik

Background: Community–acquired pneumonia (CAP) is the most common potentially fatal infectious disease in adults worldwide. Prognosis depends on many factors including nutritional status. (P.S this research began before COVID19 pandemic arrivals to our country).  Objective: The present study aims to assess the association between markers of nutritional status and severity of CAP. Materials and Methods: This is observational descriptive study conducted in the Department of Pulmonology in Tishreen University Hospital –Lattakia- Syria from November 2019 to November 2020. Adult patients with the diagnosis of CAP were enrolled in the study. Results: A total of 70 patients were included, Median age was 65 years, 40 (57.10%) were male. Serum albumin and cholesterol levels were lower in patients older than 65 years; (3.07±0.4 vs 3.5±0.5, p:0.001) and (135.2±33.2 vs 154.8±31.7, p: 0.01), respectively. Levels of albumin and cholesterol were significantly higher in survivors group; (3.6±0.4 vs. 2.7±0.3, p:0.001) and (158.3±23.9 vs. 120.3±35.08, p: 0.0001). Pearson's correlation analysis revealed negative correlation between pneumonia severity index (PSI) and: serum albumin (r = -0.61, p:0.0001), cholesterol(r = -0.45, p:0.0001) and BMI (r = -0.16, p: 0.1). The CRP showed negative correlation with serum albumin (r = -0.55, p:0.0001), cholesterol (r = -0.51 ,p:0.0001) and BMI (r = -0.09, p: 0.4). Conclusion: Serum albumin and cholesterol values were found to be related to the severity of CAP and initial levels may be a useful biomarkers to predict the outcome of patients.


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