Armstrong-James D, Copas A J, Walzer P D, Edwards S G, Miller R F
Section of Infectious Diseases and Immunity, Imperial College London.
Int J STD AIDS. 2011 Nov;22(11):628-34. doi: 10.1258/ijsa.2011.011040.
A prognostic scoring tool (PST) was created to aid prediction of outcome from HIV-associated Pneumocystis jirovecii pneumonia (PCP) using data obtained from 577 episodes of PCP among 540 patients presenting to a specialist HIV treatment centre in London, UK. It used risk factors identifiable at/soon after hospitalization, previously identified as being associated with mortality: repeat episode of PCP, patient's age, haemoglobin (Hb) and oxygen partial pressure (PaO(2)) on admission, presence of medical co-morbidity (Comorb) and of pulmonary Kaposi sarcoma (PKS). The derived PST was 25.5+(age in years/10) + 2 (if a repeat episode of PCP) + 3 (if Comorb present) + 4 (if PKS detected) - PaO(2) (kPa) - Hb (g/dL), and produced scores that ranged between 0 and 19. Patients were divided into five groups according to their prognostic score: 0-3.9 = group 1 (0% mortality), 4-7.9 = group 2 (3% mortality), 8-10.9 = group 3 (9% mortality), 11-14.9 = group 4 (29% mortality) and ≥ 15 = group 5 (52% mortality). This PST facilitates rapid identification of patients early in their hospitalization who have mild or severe HIV-associated PCP and who are at high and low risk of in-hospital death from PCP. The PST may aid assessment of severity of illness and in directing treatment strategies, but requires validation in patient cohorts from other health-care institutions.
利用从英国伦敦一家专业艾滋病治疗中心的540例患者的577次肺孢子菌肺炎（PCP）发作中获得的数据，创建了一种预后评分工具（PST），以帮助预测HIV相关的耶氏肺孢子菌肺炎（PCP）的预后。它使用了住院时/住院后不久可识别的风险因素，这些因素先前已被确定与死亡率相关：PCP复发、患者年龄、入院时的血红蛋白（Hb）和氧分压（PaO₂）、合并症（Comorb）以及肺卡波西肉瘤（PKS）的存在。得出的PST为25.5 +（年龄/10）+ 2（如果是PCP复发）+ 3（如果存在合并症）+ 4（如果检测到PKS）- PaO₂（kPa）- Hb（g/dL），产生的分数范围在0至19之间。根据预后评分将患者分为五组：0 - 3.9 =第1组（死亡率0%），4 - 7.9 =第2组（死亡率3%），8 - 10.9 =第3组（死亡率9%），11 - 14.9 =第4组（死亡率29%），≥ 15 =第5组（死亡率52%）。这种PST有助于在患者住院早期快速识别患有轻度或重度HIV相关PCP且PCP院内死亡风险高低的患者。该PST可能有助于评估疾病严重程度并指导治疗策略，但需要在其他医疗机构的患者队列中进行验证。
