Abstract
Introduction: Community acquired pneumonia(CAP) is a major cause of morbidity and mortality in elderly patients. An accurate evaluation of the appropriate site of care for elderly patients is difficult. When the PSI or CURB65 scores were used in a population of patients >65 years old, investigators found that placing patients into classes IV and V (high risk for mortality) had poor discriminating value for predicting mortality.
Aim: The comparison of the prognostic value of different scores for the outcomes of CAP in old adults.
Methods: This prospective observational study recorded the clinical course of CAP in a Greek cohort of hospitalized patients from 3 respiratory clinics, in 2010-2014. Patients >65 years old were selected and pneumonia severity indices including CURB65, IDSA/ATS rule for ICU admission and SOAR were calculated for each patient.
Results: Among the 414 patients enrolled in the study, 239 were >65 years old, 118 (49%) women. 210(88%) of them had comorbidities, more often chronic cardiac failure (52%), diabetes mellitus (30%), chronic lung (50%) and neurologic disease (22%). ATS/IDSA rule has the highest sensitivity in predicting mortality, followed by CURB65>3 and SOAR>2. ATS/IDSA rule AUC: 0,76, CURB65 (AUC:0, 71) and SOAR (AUC:0,72). For predicting ICU admission the ATS/IDSA rule( AUC: 0,73) had the same discriminating value as CURB65(AUC:0,73) better than SOAR(AUC:0,67).
Conclusion: The utility of scoring indices for severity assessment in CAP of elderly patients shows that they can be applied as in CAP.
- Copyright ©ERS 2015