Utility of the Quick Sequential Organ Failure Assessment in Japanese patients with nursing- and healthcare-associated pneumonia.

Autor: Noguchi S; Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Yatera K; Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Naito K; Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Hata R; Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Kawanami T; Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Yamasaki K; Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Kato T; Department of Respiratory Medicine, Tobata Kyoritsu Hospital, Kitakyushu, Japan., Orihashi T; Department of Respiratory Medicine, Kitakyushu General Hospital, Kitakyushu, Japan., Inoue N; Department of Internal Medicine, Kyushu Rosai Hospital, Kitakyushu, Japan., Sakamoto N; Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan., Yoshii C; Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan., Mukae H; Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Jazyk: angličtina
Zdroj: Geriatrics & gerontology international [Geriatr Gerontol Int] 2019 Mar; Vol. 19 (3), pp. 177-183. Date of Electronic Publication: 2018 Dec 16.
DOI: 10.1111/ggi.13581
Abstrakt: Aim: To clarify the utility of sepsis evaluation using the Quick Sequential Organ Failure Assessment (qSOFA) tool in addition to the Pneumonia Severity Index (PSI); age, dehydration, respiration, orientation and blood pressure (A-DROP) index; and immunodeficiency, respiration, orientation, age and dehydration (I-ROAD) scoring systems, and risk factor evaluation of potentially drug-resistant (PDR) pathogens are suggested in the 2017 guidelines for pneumonia of the Japanese Respiratory Society in nursing- and healthcare-associated pneumonia patients.
Methods: We included 289 hospitalized nursing- and healthcare-associated pneumonia patients between April 2016 and March 2017, and investigated the ability of PSI, A-DROP, I-ROAD and qSOFA to predict pneumonia-related mortality. We also evaluated the associations among the risk factors for PDR pathogens, the detection ratio of PDR pathogens and pneumonia-related mortality.
Results: The mortality rate of pneumonia during hospitalization was 6.9% (20/289). The area under the curve for pneumonia-related mortality predicted using PSI, A-DROP, I-ROAD and qSOFA was 0.697 (95% confidence interval [CI] 0.59-0.80), 0.63 (95% CI 0.51-0.76), 0.61 (95% CI 0.52-0.70) and 0.701 (95% CI 0.59-0.81), respectively. In addition, higher areas under the curve were observed for pneumonia-related mortality predicted according to a combination of PSI and hypoalbuminemia (<2.5 g/dL) (0.75, 95% CI 0.64-0.86), and qSOFA and hypoalbuminemia (0.74, 95% CI 0.62-0.86) than for PSI and qSOFA alone. No significant associations were observed among the risk factors for PDR pathogens, the detection ratios of PDR pathogens and pneumonia-related mortality.
Conclusions: qSOFA and the combination of qSOFA and hypoalbuminemia might be simple and useful evaluation tools for predicting pneumonia-related mortality in nursing- and healthcare-associated pneumonia patients. Geriatr Gerontol Int 2019; 19: 177-183.
(© 2018 Japan Geriatrics Society.)
Databáze: MEDLINE
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