Department of Emergency Medicine, Bursa City Hospital, Bursa, Turkey.
Department of Emergency Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
Indian J Med Res. 2020 Oct;152(4):368-377. doi: 10.4103/ijmr.IJMR_595_18.
BACKGROUND & OBJECTIVES: : Sepsis due to pneumonia or pneumonia itself is one of the main causes of deaths in patients despite the advanced treatment methods. The optimal prognostic tool in pneumonia is still not clear. This study was aimed to compare the pneumonia severity scores and the possibility of using the new scores in patients who were diagnosed with pneumonia in the emergency department.
: Demographic data, laboratory and imaging results, confusion, elevated blood urea nitrogen, respiratory rate and blood pressure plus age ≥65 yr (CURB-65), pneumonia severity index (PSI), national early warning score (NEWS), NEWS-lactate (NEWS-L) scores, hospitalization, referral, discharge and 30-day mortality of patients who were diagnosed with pneumonia in emergency department were recorded.
: A total of 250 patients were included in the study. The most successful score in predicted mortality was found to be NEWS-L. This was followed by NEWS, CURB-65 and PSI, respectively. Most successful scores in anticipation of admission to the intensive care unit were NEWS-L followed by NEWS. This was followed by CURB-65 and PSI scores, respectively. The most successful score in anticipation of hospital admission was NEWS-L, followed by NEWS, CURB-65 and PSI, respectively. There was a significant difference between all pneumonia severity scores of the patients who died and survived within 30 days. There was a significant difference between the scores of patients in intensive care unit (ICU) and service, compared to non-ICU patients.
INTERPRETATION & CONCLUSIONS: : NEWS-L score was found to be the most successful score in predicting mortality, ICU admission and hospitalization requirement. Both NEWS-L and NEWS scores can be used in determining the mortality, need for hospitalization and intensive care of the patients with pneumonia in the emergency department.
尽管治疗方法先进，但肺炎或肺炎引起的脓毒症仍是导致患者死亡的主要原因之一。肺炎的最佳预后工具仍不明确。本研究旨在比较肺炎严重程度评分，并探讨新评分在急诊科诊断为肺炎患者中的应用可能性。
记录急诊科诊断为肺炎的患者的人口统计学数据、实验室和影像学结果、意识障碍、血尿素氮升高、呼吸频率和血压升高（年龄≥65 岁）（CURB-65）、肺炎严重指数（PSI）、国家早期预警评分（NEWS）、NEWS-乳酸（NEWS-L）评分、住院、转科、出院和 30 天死亡率。
共纳入 250 例患者。预测死亡率最成功的评分是 NEWS-L。其次是 NEWS、CURB-65 和 PSI。预测入住重症监护病房（ICU）最成功的评分是 NEWS-L，其次是 NEWS。预测住院最成功的评分是 NEWS-L，其次是 NEWS、CURB-65 和 PSI。死亡和 30 天内存活的患者所有肺炎严重程度评分之间存在显著差异。入住 ICU 和专科病房的患者评分与非 ICU 患者存在显著差异。
NEWS-L 评分在预测死亡率、入住 ICU 和住院需求方面是最成功的评分。NEWS-L 和 NEWS 评分均可用于评估急诊科肺炎患者的死亡率、住院需求和入住 ICU 的可能性。
