社区获得性肺炎成人患者住院死亡率的 Charlson 合并症指数及其他预测因素。
Charlson Comorbidity Index and other predictors of in-hospital mortality among adults with community-acquired pneumonia.
机构信息
. Faculdade de Medicina, Universidade do Vale do Rio dos Sinos - UNISINOS - São Leopoldo (RS) Brasil.
. Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil.
出版信息
J Bras Pneumol. 2021 Feb 24;47(1):e20200257. doi: 10.36416/1806-3756/e20200257. eCollection 2021.
OBJECTIVE
To compare the performance of Charlson Comorbidity Index (CCI) with those of the mental Confusion, Urea, Respiratory rate, Blood pressure, and age = 65 years (CURB-65) score and the Pneumonia Severity Index (PSI) as predictors of all-cause in-hospital mortality in patients with community-acquired pneumonia (CAP).
METHODS
This was a cohort study involving hospitalized patients with CAP between April of 2014 and March of 2015. Clinical, laboratory, and radiological data were obtained in the ER, and the scores of CCI, CURB-65, and PSI were calculated. The performance of the models was compared using ROC curves and AUCs (95% CI).
RESULTS
Of the 459 patients evaluated, 304 met the eligibility criteria. The all-cause in-hospital mortality rate was 15.5%, and 89 (29.3%) of the patients were admitted to the ICU. The AUC for the CCI was significantly greater than those for CURB-65 and PSI (0.83 vs. 0.73 and 0.75, respectively).
CONCLUSIONS
In this sample of hospitalized patients with CAP, CCI was a better predictor of all-cause in-hospital mortality than were the PSI and CURB-65.
目的
比较 Charlson 合并症指数 (CCI) 与精神错乱、尿素、呼吸频率、血压和年龄≥65 岁 (CURB-65) 评分以及肺炎严重指数 (PSI) 在预测社区获得性肺炎 (CAP) 患者全因住院死亡率方面的性能。
方法
这是一项队列研究，纳入了 2014 年 4 月至 2015 年 3 月期间住院的 CAP 患者。在急诊室获取了临床、实验室和影像学数据，并计算了 CCI、CURB-65 和 PSI 的评分。使用 ROC 曲线和 AUC（95%CI）比较了模型的性能。
结果
在评估的 459 名患者中，有 304 名符合入选标准。全因住院死亡率为 15.5%，89 名（29.3%）患者入住 ICU。CCI 的 AUC 明显大于 CURB-65 和 PSI（分别为 0.83、0.73 和 0.75）。
结论
在本项 CAP 住院患者样本中，CCI 是全因住院死亡率的更好预测因子，优于 PSI 和 CURB-65。
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