Value of the pneumonia severity index in assessment of community-acquired pneumonia.
OBJECTIVE
The value of the Pneumonia Severity Index (PSI) in predicting the mortality of patients with community-acquired pneumonia has not been reported in Taiwan. This study investigated the value of this scoring system in estimating mortality of inpatients with community-acquired pneumonia.


METHODS
This was a prospective observational study of 118 inpatients and a retrospective chart review of 115 inpatients with radiographically-confirmed community-acquired pneumonia treated at a tertiary referral medical center in southern Taiwan. Patients were stratified into 5 risk classes according to PSI score. Data on demographic characteristics, comorbidities, baseline clinical and laboratory features, in-hospital mortality and length of hospital stay were analyzed.


RESULTS
The mortality rates according to risk classification were 0% for class I and II, 2.5% for class III, 8.2% for class IV, and 31.2% for class V. A significant correlation was found between these risk classes and medical outcome (p < 0.001). The length of hospital stay was significantly associated with risk class, and ranged from 6.3 days for class I patients to 18 days for class V (p < 0.001).


CONCLUSIONS
The PSI provided a useful prediction of medical outcome in patients with community-acquired pneumonia. To decrease unnecessary admission, further prospective studies are needed to determine whether outpatient therapy is appropriate for class I or class II patients with community-acquired pneumonia.
Lin
Chien-Chung
CC
Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Lee
Cheng-Hung
CH
Chen
Chiung-Zuei
CZ
Chu
Yuan-Chin
YC
Hung
Tsung-Jen
TJ
Chang
Han-Yu
HY
Hsiue
Tzuen-Ren
TR
D000704:Analysis of Variance; D016009:Chi-Square Distribution; D017714:Community-Acquired Infections / Q000401:mortality*; D006801:Humans; D011014:Pneumonia / Q000401:mortality*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology