Tateyama Masao, Shinzato Takashi, Haranaga Shusaku, Higa Futoshi, Naha Yui, Nakamura Hideta, Tasato Daisuke, Yara Satomi, Koide Michio, Fujita Jiro
Department of Infectious, Respiratory, and Digestive Medicine Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus.
Nihon Kokyuki Gakkai Zasshi. 2011 May;49(5):343-8.
The A-DROP is a predicting pneumonia severity index which is adopted in the Japanese Respiratory Society (JRS) guidelines. For community-acquired pneumonia, we made a modified A-DROP, adding two new index items to the current A-DROP. Then, we retrospectively compared the modified A-DROP with the current A-DROP regarding 30-day mortality.
We analyzed consecutive 227 patients hospitalized with community-acquired pneumonia (mean age 79.0 years). The added index items were respiratory rate > or = 30/min and the presence or absence of underlying diseases. There were 16 fatalities (7.0%). In the extremely severe group, the sensitivities of the 30-day death and odds ratios were 19.9% and 9.5 in the current A-DROP, but 75.0% and 14.1 for the modified A-DROP, respectively. In addition, regarding the receiver-operating characteristic (ROC) area under the curve for the 30-day death ratio, the current A-DROP and modified A-DROP were 0.807 and 0.840, respectively.
The modified A-DROP improved the ability to predict outcomes compared with the current A-DROP.
A-DROP是日本呼吸学会（JRS）指南中采用的一种预测肺炎严重程度的指标。对于社区获得性肺炎，我们对A-DROP进行了改良，在现有A-DROP基础上增加了两个新的指标项目。然后，我们对改良后的A-DROP与现有A-DROP在30天死亡率方面进行了回顾性比较。
我们分析了连续227例因社区获得性肺炎住院的患者（平均年龄79.0岁）。新增的指标项目为呼吸频率≥30次/分钟以及是否存在基础疾病。共有16例死亡（7.0%）。在极重度组中，现有A-DROP对30天死亡的敏感度和比值比分别为19.9%和9.5，而改良后的A-DROP分别为75.0%和14.1。此外，关于30天死亡率的受试者工作特征（ROC）曲线下面积，现有A-DROP和改良后的A-DROP分别为0.807和0.840。
与现有A-DROP相比，改良后的A-DROP提高了预测预后的能力。
