Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan.
Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan.
Int J Infect Dis. 2019 Jul;84:89-96. doi: 10.1016/j.ijid.2019.04.020. Epub 2019 Apr 24.
The Japanese Respiratory Society recently updated its prognostic guidelines for pneumonia, recommending that pneumonia severity be evaluated using the sequential organ failure assessment (SOFA) and quick SOFA (qSOFA) scoring systems in a therapeutic strategy flowchart. However, the efficacy and accuracy of these tools are still unknown.
All patients with community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) who were admitted to the study institution between 2014 and 2017 were enrolled in this study. Pneumonia severity on admission was evaluated by A-DROP, CURB-65, PSI, I-ROAD, qSOFA, and SOFA scoring systems. Prognostic factors for 30-day mortality were also analyzed.
This study included 406 patients, 257 male (63%) and 149 female (37%). The median age was 79 years (range 19-103 years). The 30-day and in-hospital mortality rates were both 5%. With respect to the diagnostic value of the predictive assessments for 30-day mortality, the area under the receiver operating characteristic curve (AUROC) value for the SOFA score was 0.769 for CAP patients and 0.774 for HCAP patients. Further, the AUROC values for the SOFA score in CAP and HCAP patients with a qSOFA score ≥2 were 0.829 and 0.784, respectively, for 30-day mortality.
qSOFA and SOFA scores were able to correctly evaluate the severity of CAP and HCAP.
日本呼吸学会最近更新了其肺炎预后指南，建议在治疗策略流程图中使用序贯器官衰竭评估（SOFA）和快速 SOFA（qSOFA）评分系统评估肺炎严重程度。然而，这些工具的疗效和准确性仍不清楚。
本研究纳入了 2014 年至 2017 年期间在研究机构住院的所有社区获得性肺炎（CAP）和医疗保健相关性肺炎（HCAP）患者。入院时肺炎严重程度采用 A-DROP、CURB-65、PSI、I-ROAD、qSOFA 和 SOFA 评分系统进行评估。还分析了 30 天死亡率的预后因素。
本研究共纳入 406 例患者，其中男 257 例（63%），女 149 例（37%）。中位年龄为 79 岁（19-103 岁）。30 天和住院死亡率均为 5%。关于预测评估对 30 天死亡率的诊断价值，SOFA 评分的受试者工作特征曲线（ROC）下面积（AUROC）值为 CAP 患者 0.769 和 HCAP 患者 0.774。此外，qSOFA 评分≥2 的 CAP 和 HCAP 患者的 SOFA 评分 AUROC 值分别为 0.829 和 0.784，用于预测 30 天死亡率。
qSOFA 和 SOFA 评分能够正确评估 CAP 和 HCAP 的严重程度。
