Objective To investigate the values of pneumonia severity index ( PSI) , CURB-65,plasma procalcitonin ( PCT) , C-reactive protein ( CRP) measurements for evaluation the severity of healthcare-associated pneumonia ( HCAP) .
Methods A retrospective observational study was conducted on 92 hospitalized patients with HCAP admitted between June 2010 and December 2011. They were divided into different groups according to different severity assessment criteria. The variance and correlation of PCT,CRP,WBC and percent of neutrophil ( Neu% ) levels were compared among different groups. ROC curve
was established to analyze PSI, CURB-65, PCT and CRP levels for predicting the motality of HCAP patients.
Results In the severe HCAP group, PSI and CURB-65 scoring and serum PCT, CRP, WBC, Neu% levels were significantly higher than those in the non-severe HCAP group( P lt; 0. 05) . In the high-risk HCAP group, PCT, CRP, WBC and Neu% levels were significantly higher than those in the low-risk HCAP group according to the PSI and CURB-65 scoring criteria( P lt;0. 05) .WBC and Neu% levels were also significantly higher than those in the moderate-risk group. PSI and CURB-65 scoring were positively correlated with PCT and CRP levels. PSI scoring gt;120 points or CURB-65 scoring gt;2 points on admission were predictors of mortality.
Conclusions PSI and CURB-65 scoring are correlated with severity of HCAP. Combining serum PCT and CRP levels can improve the predictive accuracy of the severity of HCAP.
Citation：
LIU Xuedong,HAN Xiudi,LUAN Nianxu,WEI Dong,LIU Yuzhan,SHI Yi.. Usefulness of Pneumonia Severity Index and CURB-65 for Severity Evaluation of Healthcareassociated Pneumonia. Chinese Journal of Respiratory and Critical Care Medicine, 2013, 12(5): 457-460. doi: DOI: 10 . 7507 /1671 -6205 . 20130110
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
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- 1. 参考文献.
- 2. American Thoracic Society; Infectious Diseases Society of America.Guidelines for the management of adults with hospital-acquired,ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med, 2005, 171: 388-416 .
- 3. 中华医学会呼吸病学分会. 社区获得性肺炎诊断和治疗指南.中华结核和呼吸杂志, 2006, 29 : 651-655 .
- 4. Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med, 1997, 336: 243-250.
- 5. Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax, 2003;58:377-382.
- 6. Kollef MH, Shorr A, Tabak YP, et al. Epidemiology and outcomes of health-care-associated pneumonia: results from a large US database of culture-positive pneumonia. Chest, 2005, 128 : 3854 -3862.
- 7. CarratalàJ, Mykietiuk A, Fernández-SabéN, et al. Health careassociated pneumonia requiring hospital admission: epidemiology,antibiotic therapy, and clinical outcomes. Arch Intern Med, 2007 ,.
- 8. Shindo Y, Sato S, Maruyama E, et al. Health-care-associated pneumonia among hospitalized patients in a Japanese community hospital. Chest, 2009 , 135: 633-640 .
- 9. Micek ST, Kollef KE, Reichley RM, et al. Health care-associatedpneumonia and community-acquired pneumonia: a single-center experience. Antimicrob Agents Chemother, 2007, 51 : 3568 -3573 .
- 10. Fang WF, Yang KY, Wu CL, et al. Application and comparison of scoring indices to predict outcomes in patients with healthcareassociated pneumonia. Crit Care, 2011 , 15: R32.
- 11. Hirakata Y, Yanagihara K, Kurihara S, et al. Comparison of usefulness of plasma procalcitonin and C-reactive protein measurements for estimation of severity in adults with community-acquired pneumonia.Diagn Microbiol Infect Dis, 2008,61:170-174.
- 12. Krüger S, Ewig S, Marre R, Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes. Eur Respir J, 2008 , 31: 349 -355.
- 13. : 1393-1399.
