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2013, Number 3

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Rev cubana med 2013; 52 (3)

Prognostic index of mortality in community-acquired pneumonia

Álvarez AA, Maceo GLR, Barzaga MS

Language: Spanish
References: 21
Page: 173-188
PDF size: 249.05 Kb.


ABSTRACT

Background: the decision to admit a patient to hospital with community-acquired pneumonia is based on the use of prognostic scales, such as the Fine scale and the CURB-65 score, but they do not always adjust to a particular geographical context.
Objective: to create and validate an index based on prognostic factors that allow predicting the risk of death in adults older than 18 years of age with the diagnosis of community-acquired pneumonia (CAP).
Methods: the construction and validation of a prognostic index of mortality by CAP was made by a cohort study in patients who were admitted to the following Medical Centers for Comprehensive Diagnosis: "Gustavo Contreras" in the State of Carabobo; "Ciudad Piar" and "Los Caribes" in Bolívar State; and "Dr. Julio Rodríguez", and "Fe y Alegría" in the State of Sucre, Venezuela, from October 1, 2010 to September 30, 2011.
Results: the most independent prognostic factor was the shock (OR 7,929; CI 2,899-21,682). An index with 2 variants was obtained, a quantitative and an ordinal variant with 3 risk categories. The discrimination capacity (area under the ROC curve of 0.910) and the calibration of the index (0,585) were both adequate. The construction, criterion and reliability validities were determined as well as the internal consistence of the scale.
Conclusion: a prognostic index was created and validated for community-acquired pneumonia with high sensitivity and high negative predictive value; so, its introduction in the clinical practice will improve the evaluation of these patients.


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