Nobutaka Hirooka1, Tomohiro Nakayama2, Takehito Kobayashi2, Hidetomo Nakamoto2. 1. Department of General Internal Medicine, Saitama Medical University, Morohongo 38, Moroyama-chou, Iruma-gun, Saitama, Japan 350-0495 nkaorohi@saitama-med.ac.jp. 2. Department of General Internal Medicine, Saitama Medical University, Morohongo 38, Moroyama-chou, Iruma-gun, Saitama, Japan 350-0495.
Abstract
Objective: Designing an efficient management strategy for aspiration is of high priority in our aging society because of its high incidence. We evaluated the prognostic value of both the A-DROP (age, dehydration, respiratory, disorientation, and pressure) and the modified A-DROP scoring systems (adding respiratory rate and comorbidity to A-DROP) in patients with aspiration pneumonia.Design: This is a retrospective study using electronic medical records at Saitama Medical University (SMU) hospital.Setting: A 965-bed university tertiary medical center in Japan.Participants: Data were extracted from the electronic medical records of patients from SMU hospital. Methods: In-hospital mortality was compared between two groups: (1) those with a 'severe' to 'advanced severe' A-DROP score; and (2) those with a 'low' to 'middle' A-DROP score. Area under the curve (AUC) for mortality for both the A-DROP and modified A-DROP scoring systems were compared. Results: The in-hospital mortality rates for patients with a high and a low A-DROP score were 28.6% and 9.0%, respectively. The mortality rates in the high modified A-DROP score group and in the low modified A-DROP score group were 28.2% and 9.9%, respectively. These differences in the mortality rates between the two groups were statistically significant for both the A-DROP and the modified A-DROP scoring systems. The AUC of the receiver operating characteristics curve for the A-DROP (0.700; 95% confidence interval, 0.608-0.779) was statistically significant. Conclusion: The A-DROP and modified A-DROP scoring systems are associated with in-hospital mortality in patients with aspiration pneumonia. The A-DROP scoring system is easy to use and may be a clinically valuable tool in the management of aspiration pneumonia.
Objective: Designing an efficient management strategy for aspiration is of high priority in our aging society because of its high incidence. We evaluated the prognostic value of both the A-DROP (age, dehydration, respiratory, disorientation, and pressure) and the modified A-DROP scoring systems (adding respiratory rate and comorbidity to A-DROP) in patients with aspiration pneumonia.Design: This is a retrospective study using electronic medical records at Saitama Medical University (SMU) hospital.Setting: A 965-bed university tertiary medical center in Japan.Participants: Data were extracted from the electronic medical records of patients from SMU hospital. Methods: In-hospital mortality was compared between two groups: (1) those with a 'severe' to 'advanced severe' A-DROP score; and (2) those with a 'low' to 'middle' A-DROP score. Area under the curve (AUC) for mortality for both the A-DROP and modified A-DROP scoring systems were compared. Results: The in-hospital mortality rates for patients with a high and a low A-DROP score were 28.6% and 9.0%, respectively. The mortality rates in the high modified A-DROP score group and in the low modified A-DROP score group were 28.2% and 9.9%, respectively. These differences in the mortality rates between the two groups were statistically significant for both the A-DROP and the modified A-DROP scoring systems. The AUC of the receiver operating characteristics curve for the A-DROP (0.700; 95% confidence interval, 0.608-0.779) was statistically significant. Conclusion: The A-DROP and modified A-DROP scoring systems are associated with in-hospital mortality in patients with aspiration pneumonia. The A-DROP scoring system is easy to use and may be a clinically valuable tool in the management of aspiration pneumonia.
Authors: M J Fine; T E Auble; D M Yealy; B H Hanusa; L A Weissfeld; D E Singer; C M Coley; T J Marrie; W N Kapoor Journal: N Engl J Med Date: 1997-01-23 Impact factor: 91.245