BACKGROUND: Community-acquired pneumonia (CAP) severity scores can identify patients at low risk for mortality who may be suitable for ambulatory care. Here, we follow the clinical course of hospitalized patients with CAP due to 2009 H1N1 influenza. OBJECTIVE: To evaluate the role of CAP severity scores as predictors of mortality. METHODS: This was a secondary data analysis of patients hospitalized with CAP due to 2009 H1N1 influenza confirmed by reverse transcriptase polymerase chain reaction enrolled in the CAPO (Community-Acquired Pneumonia Organization) international cohort study. CAP severity scores PSI (Pneumonia Severity Index), CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥ 65 years) and CRB-65 (confusion, respiratory rate, blood pressure, age ≥ 65 years) were calculated. Actual and predicted mortality rates were compared. A total of 37 predictor variables were evaluated to define those associated with mortality. RESULTS: Data from 250 patients with CAP due to 2009 H1N1 influenza were analyzed. Patients with low predicted mortality rates (0-1.5%) had actual mortality rates ranging from 2.6% to 17.5%. Obesity and wheezing were the only novel variables associated with mortality. CONCLUSIONS: The decision to hospitalize a patient with CAP due to 2009 H1N1 influenza should not be based on current CAP severity scores, as they underestimate mortality rates in a significant number of patients. Patients with obesity or wheezing should be considered at an increased risk for mortality.
BACKGROUND: Community-acquired pneumonia (CAP) severity scores can identify patients at low risk for mortality who may be suitable for ambulatory care. Here, we follow the clinical course of hospitalized patients with CAP due to 2009 H1N1 influenza. OBJECTIVE: To evaluate the role of CAP severity scores as predictors of mortality. METHODS: This was a secondary data analysis of patients hospitalized with CAP due to 2009 H1N1 influenza confirmed by reverse transcriptase polymerase chain reaction enrolled in the CAPO (Community-Acquired Pneumonia Organization) international cohort study. CAP severity scores PSI (Pneumonia Severity Index), CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥ 65 years) and CRB-65 (confusion, respiratory rate, blood pressure, age ≥ 65 years) were calculated. Actual and predicted mortality rates were compared. A total of 37 predictor variables were evaluated to define those associated with mortality. RESULTS: Data from 250 patients with CAP due to 2009 H1N1 influenza were analyzed. Patients with low predicted mortality rates (0-1.5%) had actual mortality rates ranging from 2.6% to 17.5%. Obesity and wheezing were the only novel variables associated with mortality. CONCLUSIONS: The decision to hospitalize a patient with CAP due to 2009 H1N1 influenza should not be based on current CAP severity scores, as they underestimate mortality rates in a significant number of patients. Patients with obesity or wheezing should be considered at an increased risk for mortality.
Authors: Erick J Rendón-Ramirez; Alejandro Ortiz-Stern; Corazon Martinez-Mejia; Mario C Salinas-Carmona; Adrian Rendon; Viviana L Mata-Tijerina; Adrian G Rosas-Taraco Journal: Viral Immunol Date: 2015-04-29 Impact factor: 2.257
Authors: Miguel Delgado-Rodríguez; Jesús Castilla; Pere Godoy; Vicente Martín; Nuria Soldevila; Jordi Alonso; Jenaro Astray; Maretva Baricot; Rafael Cantón; Ady Castro; Fernando Gónzález-Candelas; José María Mayoral; José María Quintana; Tomás Pumarola; Sonia Tamames; Marc Sáez; Angela Domínguez Journal: J Antimicrob Chemother Date: 2012-03-30 Impact factor: 5.790
Authors: Deshayne B Fell; Eduardo Azziz-Baumgartner; Michael G Baker; Maneesh Batra; Julien Beauté; Philippe Beutels; Niranjan Bhat; Zulfiqar A Bhutta; Cheryl Cohen; Bremen De Mucio; Bradford D Gessner; Michael G Gravett; Mark A Katz; Marian Knight; Vernon J Lee; Mark Loeb; Johannes M Luteijn; Helen Marshall; Harish Nair; Kevin Pottie; Rehana A Salam; David A Savitz; Suzanne J Serruya; Becky Skidmore; Justin R Ortiz Journal: Vaccine Date: 2017-09-01 Impact factor: 3.641