Efrén Murillo-Zamora1, Alfredo Medina-González2, Liliana Zamora-Pérez3, Andrés Vázquez-Yáñez4, José Guzmán-Esquivel5, Benjamín Trujillo-Hernández6. 1. Departamento de Epidemiología, Unidad de Medicina Familiar n.(o) 19, Instituto Mexicano del Seguro Social, Colima, Colima, Méjico. 2. Coordinación de Planeación y Enlace Institucional, Jefatura de Servicios de Prestaciones Médicas, Instituto Mexicano del Seguro Social, Colima, Colima, Méjico. 3. Departamento de Medicina Interna, Hospital General de Zona n.(o) 1, Instituto Mexicano del Seguro Social, Villa de Álvarez, Colima, Méjico. 4. Departamento de Epidemiología, Hospital General de Zona n.(o) 10, Instituto Mexicano del Seguro Social, Manzanillo, Colima, Méjico. 5. Unidad de Investigación en Epidemiología Clínica, Hospital General de Zona n.(o) 1, Instituto Mexicano del Seguro Social, Villa de Álvarez, Colima, Méjico. Electronic address: pepeguzman_esquivel@outlook.com. 6. Facultad de Medicina, Universidad de Colima, Colima, Colima, Méjico.
Abstract
INTRODUCTION: Healthcare-associated pneumonia (HCAP) is the leading cause of infection in a hospital setting and is associated with a high mortality rate. This study aimed to evaluate the performance of the pneumonia severity index (PSI) and confusion, urea, respiratory rate, blood pressure, age≥65 (CURB-65) systems in predicting 30-day mortality in HCAP in adult patients. PATIENTS AND METHODS: A cross-sectional study took place and data from 109 non-immunocompromised individuals aged>18 years were analyzed. The clinical diagnosis of HCAP included the presence of radiographic infiltrates in patients≥48hours after hospital admission. The PSI and CURB-65 scores were calculated and performance measures were estimated. Summary statistics were used to describe the study sample. The PSI and CURB-65 scores were calculated based on 20 and 5 criteria, respectively, and the performance indicators of the screening tools were estimated. RESULTS: The overall 30-day mortality was 59.6%. At every given threshold, PSI sensitivity was higher, but showed a lower specificity than the CURB-65, and the highest Youden index (0.392) was observed at cut-off V in the PSI. The area under the ROC curve was 0.737 (95% CI: 0.646-0.827) and 0.698 (95% CI: 0.600-0.797) using the PSI and CURB-65 systems, respectively (P=.323). CONCLUSION: Our findings suggest that the performance of the PSI and CURB-65 is reasonable for predicting 30-day mortality in adult HCAP patients and may be used in healthcare settings.
INTRODUCTION:Healthcare-associated pneumonia (HCAP) is the leading cause of infection in a hospital setting and is associated with a high mortality rate. This study aimed to evaluate the performance of the pneumonia severity index (PSI) and confusion, urea, respiratory rate, blood pressure, age≥65 (CURB-65) systems in predicting 30-day mortality in HCAP in adult patients. PATIENTS AND METHODS: A cross-sectional study took place and data from 109 non-immunocompromised individuals aged>18 years were analyzed. The clinical diagnosis of HCAP included the presence of radiographic infiltrates in patients≥48hours after hospital admission. The PSI and CURB-65 scores were calculated and performance measures were estimated. Summary statistics were used to describe the study sample. The PSI and CURB-65 scores were calculated based on 20 and 5 criteria, respectively, and the performance indicators of the screening tools were estimated. RESULTS: The overall 30-day mortality was 59.6%. At every given threshold, PSI sensitivity was higher, but showed a lower specificity than the CURB-65, and the highest Youden index (0.392) was observed at cut-off V in the PSI. The area under the ROC curve was 0.737 (95% CI: 0.646-0.827) and 0.698 (95% CI: 0.600-0.797) using the PSI and CURB-65 systems, respectively (P=.323). CONCLUSION: Our findings suggest that the performance of the PSI and CURB-65 is reasonable for predicting 30-day mortality in adult HCAPpatients and may be used in healthcare settings.