Comparison of severity predictive rules for hospitalised nursing home-acquired pneumonia in Korea: a retrospective observational study.

摘要: BACKGROUND Nursing home-acquired pneumonia (NHAP) is the leading cause of death among long-term care residents. AIMS To compare current scoring indices (NHAP model score, Pneumonia Severity Index (PSI), CURB-65 (confusion, urea nitrogen, respiratory rate, blood pressure, age >65 years) and SOAR (systolic oxygenation, age, rate)) in predicting mortality admission to intensive unit (ICU) patients with NHAP. METHODS This retrospective observational study was conducted between July 2008 June 2011 using data from Korean Home Networks. Two hundred eight nursing home residents were hospitalised one general hospital. The primary outcome measure 30-day all-cause mortality. Secondary measures or vasopressor support (IRVS), severe (ICU IRVS). RESULTS PSI class V showed highest Youden index (0.45), specificity (66.7%), positive predictive value (PPV, 40.0%), negative (NPV, 91.5%), area under curve (AUC, 0.73) for For pneumonia, (0.40), (72.8%), PPV (62.2%), NPV (77.1%), AUC (0.70). Similarly, (0.35), (68.3%), (51.1%), (80.5%), (0.69) IRVS. CONCLUSIONS has superior discriminatory power all three clinical outcomes (30-day mortality, IVRS) compared NHAP SOAR.