医学
置信区间
社区获得性肺炎
接收机工作特性
内科学
肺炎
前瞻性队列研究
队列
作者
Masahiro Shirata,Isao Ito,Tadashi Ishida,Hiromasa Tachibana,Naoya Tanabe,Satoshi Konishi,Issei Oi,Nobuyoshi Hamao,Kensuke Nishioka,Hisako Matsumoto,Yoshiro Yasutomo,Seizo Kadowaki,Hisashi Ohnishi,Hiromi Tomioka,Takashi Nishimura,Yoshinori Hasegawa,Atsushi Nakagawa,Toyohiro Hirai
标识
DOI:10.1038/s41598-021-03440-3
摘要
The discriminative power of CURB-65 for mortality in community-acquired pneumonia (CAP) is suspected to decrease with age. However, a useful prognostic prediction model for older patients with CAP has not been established. This study aimed to develop and validate a new scoring system for predicting mortality in older patients with CAP. We recruited two prospective cohorts including patients aged ≥ 65 years and hospitalized with CAP. In the derivation (n = 872) and validation cohorts (n = 1,158), the average age was 82.0 and 80.6 years and the 30-day mortality rate was 7.6% (n = 66) and 7.4% (n = 86), respectively. A new scoring system was developed based on factors associated with 30-day mortality, identified by multivariate analysis in the derivation cohort. This scoring system named CHUBA comprised five variables: confusion, hypoxemia (SpO2 ≤ 90% or PaO2 ≤ 60 mmHg), blood urea nitrogen ≥ 30 mg/dL, bedridden state, and serum albumin level ≤ 3.0 g/dL. With regard to 30-day mortality, the area under the receiver operating characteristic curve for CURB-65 and CHUBA was 0.672 (95% confidence interval, 0.607-0.732) and 0.809 (95% confidence interval, 0.751-0.856; P < 0.001), respectively. The effectiveness of CHUBA was statistically confirmed in the external validation cohort. In conclusion, a simpler novel scoring system, CHUBA, was established for predicting mortality in older patients with CAP.
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