Simple criteria to assess mortality in patients with community-acquired pneumonia.
OBJECTIVE
The Pneumonia Patient Outcomes Research Team (PORT) developed a prediction rule to identify patients with community-acquired pneumonia (CAP) who are at risk for death and other adverse outcomes. Simpler criteria are needed to evaluate risk of mortality in CAP.


METHODS
Observational study of patients with CAP admitted to a tertiary care university hospital. Epidemiological, clinical, radiological and laboratory data associated with mortality were analysed.


RESULTS
A cohort of 211 patients with CAP was studied. Severity distribution according to PORT score was 12.3%, 15.6%, 19%, 35.5% and 17.5% in groups I, II, III, IV and V, respectively; mean age was 63 years (range, 13 to 100 years); in 43.6% age was < 65 years; 61.5% patients had > or = 1 underlying disease (congestive heart failure in 33.6% and chronic lung disease in 29.9%). Mortality rate was 0% in groups I-II, 2.5% in group III, 5.3% in group IV and 27% in group V. All variables considered in PORT-score were included in a mortality predicting model; factors significantly associated with death were: altered mental status, respiratory rate > or = 30/min, pH < 7.35, glucose > or = 250 mg/dl and age > 65 years; 99% of patients who had none of these abnormalities survived.


CONCLUSIONS
Simpler criteria to assess mortality in CAP were identified. Non-existence of altered mental status, respiratory rate > or = 30/min, pH < 7.35, glucose > or = 250 mg/dl and age > 65 years predicted a non-fatal outcome in 99% of patients. These clinical or laboratory findings should be considered as mortality predictors, can be used as severity adjustment measure and may help physicians make more rational decisions about hospitalization in CAP.
García-Vázquez
Elisa
E
Departamento de Medicina Interna-Enfermedades Infecciosas, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain. elisag@eresmas.net
Soto
Silvia
S
Gómez
Joaquín
J
Herrero
José-Antonio
JA
D000368:Aged; D017714:Community-Acquired Infections / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000401:mortality*; D012189:Retrospective Studies