Department of General Internal Medicine, Saitama Medical University, Morohongo 38, Moroyama-chou, Iruma-gun, Saitama, Japan 350-0495
Department of General Internal Medicine, Saitama Medical University, Morohongo 38, Moroyama-chou, Iruma-gun, Saitama, Japan 350-0495.
Clin Med Res. 2021 Jun;19(2):47-53. doi: 10.3121/cmr.2020.1560. Epub 2021 Feb 5.
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. This is a retrospective study using electronic medical records at Saitama Medical University (SMU) hospital. A 965-bed university tertiary medical center in Japan. Data were extracted from the electronic medical records of patients from SMU hospital. 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. 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. 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.
设计一种有效的吸入管理策略是我们老龄化社会的当务之急，因为吸入的发病率很高。我们评估了 A-DROP（年龄、脱水、呼吸、定向障碍和压力）和改良 A-DROP 评分系统（在 A-DROP 中添加呼吸频率和合并症）在吸入性肺炎患者中的预后价值。这是一项使用日本埼玉医科大学（SMU）医院电子病历的回顾性研究。SMU 是一家拥有 965 张床位的日本大学三级医疗中心。从 SMU 医院的电子病历中提取数据。比较两组患者的院内死亡率：（1）A-DROP 评分“严重”至“严重”的患者；和（2）A-DROP 评分“低”至“中”的患者。比较 A-DROP 和改良 A-DROP 评分系统的死亡率曲线下面积（AUC）。高和低 A-DROP 评分患者的院内死亡率分别为 28.6%和 9.0%。高改良 A-DROP 评分组和低改良 A-DROP 评分组的死亡率分别为 28.2%和 9.9%。两组死亡率差异均有统计学意义。A-DROP（0.700；95%置信区间，0.608-0.779）的受试者工作特征曲线 AUC 有统计学意义。A-DROP 和改良 A-DROP 评分系统与吸入性肺炎患者的院内死亡率相关。A-DROP 评分系统易于使用，可能是管理吸入性肺炎的一种有价值的临床工具。
