Validation of the qSOFA score compared to the CRB-65 score for risk prediction in community-acquired pneumonia

被引:8
|
作者
Kesselmeier, Miriam [1 ,2 ]
Pletz, Mathias W. [3 ]
Blankenstein, Anna Leona [4 ]
Scherag, Andre [1 ,2 ]
Bauer, Torsten [5 ]
Ewig, Santiago [6 ]
Kolditz, Martin [4 ]
机构
[1] Jena Univ Hosp, Integrated Res & Treatment Ctr, Ctr Sepsis Control & Care CSCC, Res Grp Clin Epidemiol, Jena, Germany
[2] Jena Univ Hosp, Inst Med Stat Comp & Data Sci, Jena, Germany
[3] Jena Univ Hosp, Inst Infect Dis & Infect Control, Jena, Germany
[4] Tech Univ Dresden, Div Pulmonol, Med Dept 1, Univ Hosp Carl Gustav Carus, Dresden, Germany
[5] HELIOS Klinikum Emil von Behring, Lungenklin Heckeshorn, Dept Pneumol, Berlin, Germany
[6] EVK Herne & Augusta Kranken Anstalt Bochum, Thoraxzentrum Ruhrgebiet, Dept Resp & Infect Dis, Bochum, Germany
关键词
Community-acquired pneumonia; Mortality; Prognosis; Risk stratification; Sepsis; SEVERITY; SEPSIS; BURDEN; ADULTS;
D O I
10.1016/j.cmi.2020.10.008
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objective: The qSOFA (quick sepsis-related organ failure assessment) score shows similarities to the CRB-65 pneumonia score, but its prognostic accuracy in patients with community-acquired pneumonia (CAP) has not been extensively evaluated. Our aim was to validate the qSOFA (-65) score in a large cohort of CAP patients. Methods: We conducted a retrospective population-based cohort study including all CAP cases hospitalized between 1st January 2014 and 31st December 2018 from the German nationwide mandatory quality assurance programme. We excluded cases transferred from another hospital, with mechanical ventilation present on admission, and without documented respiratory rate. Predefined outcomes were hospital mortality and need for mechanical ventilation. Results: Among the 1,262,250 included cases, hospital mortality was 12.4% and the mechanical ventilation rate was 7.1%. All CRB and qSOFA criteria were associated with both outcomes, but the qSOFA had inferior sensitivity compared to the CRB-65 for mortality prediction. Including the age criterion >= 65 years, qSOFA-65 and CRB-65 performed similarly (AUC 0.69, 95%CI 0.69-0.69 versus 0.68, 95%CI 0.68-0.68). A qSOFA-65 of 0 was associated with fewer missed deaths (3328, 2.0%) compared to a CRB-65 of 0 (5480, 2.4%). The sensitivity of the suggested qSOFA cut-off of >= 2 for sepsis was low (mortality 25.8%, 95%CI 25.6-26.0%; mechanical ventilation 24.1%, 95%CI 23.8-24.4%). Results were similar when frail and palliative patients were excluded. Conclusions: The qSOFA parameters show prognostic accuracy similar to the CRB parameters in CAP, but the sepsis cut-off of >= 2 lacked sensitivity. For sensitive mortality prediction, the age criterion >= 65 years should be added to the qSOFA. (C) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:1345.e1 / 1345.e6
页数:6
相关论文
共 50 条
  • [21] The role of qSOFA score and biomarkers in assessing severity of community-acquired pneumonia in adults
    Tripon, Raluca-Elena
    Cristea, Victor
    Lupse, Mihaela-Sorina
    REVISTA ROMANA DE MEDICINA DE LABORATOR, 2021, 29 (01): : 65 - 75
  • [22] Comparison of CURB-65 and CRB-65 as predictors of death in community-acquired pneumonia in adults admitted to an ICU
    AR Santana
    FF Amorim
    FB Soares
    LG de Souza Godoy
    L de Jesus Almeida
    TA Rodrigues
    GM de Andrade Filho
    TA Silva
    OG da Silva Neto
    PHG Rocha
    PN Ferreira
    APP Amorim
    E Bastos de Moura
    JA de Araújo Neto
    M de Oliveira Maia
    Critical Care, 17 (Suppl 3):
  • [23] Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes
    Krueger, S.
    Ewig, S.
    Marre, R.
    Papassotiriou, J.
    Richter, K.
    von Baum, H.
    Suttorp, N.
    Welte, T.
    EUROPEAN RESPIRATORY JOURNAL, 2008, 31 (02) : 349 - 355
  • [24] EMR Combined with CRB-65 Superior to CURB-65 in Predicting Mortality in Patients with Community-Acquired Pneumonia
    Sun, Yi
    Wang, Hong
    Gu, Minghao
    Zhang, Xingyu
    Han, Xiudi
    Liu, Xuedong
    INFECTION AND DRUG RESISTANCE, 2024, 17 : 463 - 473
  • [25] Cost analysis of therapy in the treatment of community-acquired pneumonia (CAP) - the influence of severity according to CRB-65
    Ott, S. R.
    Welte, T.
    Ernen, C.
    Lepper, P. M.
    Hauptmeier, B. M.
    Bauer, T. T.
    INFECTION, 2009, 37 : 16 - 17
  • [26] EMR Combined with CRB-65 Superior to CURB-65 in Predicting Mortality in Patients with Community-Acquired Pneumonia [Letter]
    Rusdi, Achmad Jaelani
    Afifah, Lilik
    INFECTION AND DRUG RESISTANCE, 2024, 17 : 1229 - 1230
  • [27] Predicting death in elderly patients with community-acquired pneumonia: A prospective validation study reevaluating the CRB-65 severity assessment tool
    Bont, Jettie
    Hak, Eelko
    Hoes, Arno W.
    Macfarlane, John T.
    Verheij, Theo J. M.
    ARCHIVES OF INTERNAL MEDICINE, 2008, 168 (13) : 1465 - 1468
  • [28] Validation of the PES Prediction Score for the Causative Different to Treat Microorganisms in Community-Acquired Pneumonia
    Ceccato, A.
    Mendez, R.
    Ewig, S.
    de la Torre, M.
    Cilloniz, C.
    Gabarrus, A.
    Prina, E.
    Ranzani, O. T.
    Ferrer Monreal, M.
    Almirall, J.
    Menendez, R.
    Torres, A.
    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2020, 201
  • [29] Validation of the Hospital Frailty Risk Score in older adults hospitalized with community-acquired pneumonia
    Rosario, Barbara H.
    Quah, Jessica Lishan
    Chang, Ting Yu
    Barrera, Vivian Cantiller
    Lim, Aileen
    Sim, Lydia Euphemia
    Conroy, Simon
    Dhaliwal, Trishpal Kaur
    GERIATRICS & GERONTOLOGY INTERNATIONAL, 2024, 24 : 135 - 141
  • [30] EMR Combined with CRB-65 Superior to CURB-65 in Predicting Mortality in Patients with Community-Acquired Pneumonia [Response to Letter]
    Sun, Yi
    Wang, Hong
    Gu, Minghao
    Zhang, Xingyu
    Han, Xiudi
    Liu, Xuedong
    INFECTION AND DRUG RESISTANCE, 2024, 17 : 1321 - 1322