• BMC pulmonary medicine · Mar 2016

    A mortality prediction rule for non-elderly patients with community-acquired pneumonia.

    • Masato Tashiro, Kiyohide Fushimi, Takahiro Takazono, Shintaro Kurihara, Taiga Miyazaki, Misuzu Tsukamoto, Katsunori Yanagihara, Hiroshi Mukae, Takayoshi Tashiro, Shigeru Kohno, and Koichi Izumikawa.
    • Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. mtashiro@nagasaki-u.ac.jp.
    • BMC Pulm Med. 2016 Mar 8; 16: 39.

    BackgroundNo mortality prediction rule is suited for non-elderly patients with community-acquired pneumonia. Therefore, we tried to create a mortality prediction rule that is simple and suitable for non-elderly patients with community-acquired pneumonia.MethodsBecause of low mortality at young age, we used information from an administrative database that included A-DROP data. We analysed the rate and risk factors for in-hospital community-acquired pneumonia-associated death among non-elderly patients and created a mortality prediction rule based on those risk factors.ResultsWe examined 49,370 hospitalisations for patients aged 18-64 years with community-acquired pneumonia. The 30-day fatality rate was 1.5%. Using regression analysis, five risk factors were selected: patient requires help for feeding, the existence of malignancy, confusion, low blood pressure, and age 40-64 years. Each risk factor of our proposed mortality risk scoring system received one point. A total point score for each patient was obtained by summing the points. The negative likelihood ratio for the score 0 group was 0.01, and the positive likelihood ratio for the score ≥4 group was 19.9. The area under the curve of the risk score for non-elderly (0.86, 95% confidence interval: 0.84-0.87) was higher than that of the A-DROP score (0.72, 95% confidence interval: 0.70-0.74) (P < 0.0001).ConclusionsOur newly proposed mortality risk scoring system may be appropriate for predicting mortality in non-elderly patients with community-acquired pneumonia. It showed a possibility of a better prediction value than the A-DROP and is easy to use in various clinical settings.

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