title: [Pneumonia Severity Index (PSI), CURB-65, and mortality in hospitalized elderly patients with aspiration pneumonia].
abstract: BACKGROUND
  Aspiration pneumonia is associated with a high morbidity and mortality in elderly patients. In order to provide risk-adapted medical care, it is necessary to establish valid prognostic tools for these patients.
  
  
  OBJECTIVE
  The value of two well-established scores to assess prognosis in community-acquired pneumonia (CAP), i.e., CURB-65 and the Pneumonia Severity Index (PSI), was evaluated in elderly patients hospitalized for aspiration pneumonia.
  
  
  METHODS
  A total of 209 patients hospitalized with aspiration pneumonia between 2001 and 2005 in a single center were evaluated using PSI and CURB-65. For comparison of morbidity and mortality, an equally large group of inpatients with CAP was analyzed.
  
  
  RESULTS
  The mean age of patients with aspiration pneumonia was 76.7 ± 13.4 years, and 104 (49.8 %) were female. Patients with aspiration pneumonia more frequently showed a history of cancer, hypotension, and hyponatriemia on admission. Mortality was clearly higher in comparison to patients with CAP (39.2% vs. 16.3%). The Odds Ratio (OR) for mortality was 1.03 (95% CI 0.59; 1.79) for a CURB-65 score of 3-5 points compared to 0-2 points. In cases of CAP, OR showed a statistically significant increase of risk (OR 2.50; 95% CI 1.04; 6.06), for CURB-65 scores of 3-5 points vs. 0-2 points). In aspiration pneumonia, the PSI showed a trend towards increasing mortality within higher risk class.
  
  
  CONCLUSIONS
  In geriatric patients hospitalized with aspiration pneumonia, CURB-65 and PSI have no prognostic value.
authors.affiliation: Klinik für Notfall- und internistische Intensivmedizin, Klinikum Nürnberg, Nürnberg, Deutschland.
authors.forename: H J
authors.initials: HJ
authors.lastname: Heppner
authors.forename: B
authors.initials: B
authors.lastname: Sehlhoff
authors.forename: D
authors.initials: D
authors.lastname: Niklaus
authors.forename: L
authors.initials: L
authors.lastname: Pientka
authors.forename: U
authors.initials: U
authors.lastname: Thiem
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011015:Pneumonia, Aspiration / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality*; D011379:Prognosis; D016019:Survival Analysis