title: In-hospital mortality risk factors in community acquired pneumonia: evaluation of immunocompetent adult patients without comorbidities.
abstract: OBJECTIVE
  several scores were developed in order to improve the determination of community acquired pneumonia (CAP) severity and its management, mainly CURB-65 and SACP score. However, none of them were evaluated for risk assessment of in-hospital mortality, particularly in individuals who were non-immunosuppressed and/or without any comorbidity. In this regard, the present study was carried out.
  
  
  METHODS
  we performed a cross-sectional study in 272 immunocompetent patients without comorbidities and with a diagnosis of CAP. Performance of CURB- 65 and SCAP scores in predicting in-hospital mortality was evaluated. Also, variables related to death were assessed. Furthermore, in order to design a model of in-hospital mortality prediction, sampled individuals were randomly divided in two groups. The association of the variables with mortality was weighed and, by multiple binary regression, a model was constructed in one of the subgroups. Then, it was validated in the other subgroup.
  
  
  RESULTS
  both scores yielded a fair strength of agreement, and CURB-65 showed a better performance in predicting in-hospital mortality. In our casuistry, age, white blood cell counts, serum urea and diastolic blood pressure were related to death. The model constructed with these variables showed a good performance in predicting in-hospital mortality; moreover, only one patient with fatal outcome was not correctly classified in the group where the model was constructed and in the group where it was validated.
  
  
  CONCLUSIONS
  our findings suggest that a simple model that uses only 4 variables, which are easily accessible and interpretable, can identify seriously ill patients with CAP.
authors.affiliation: Internal Medicine Service, Hospital José Bernardo Iturraspe, Santa Fe, Argentina.
authors.forename: Miguel Hernan
authors.initials: MH
authors.lastname: Vicco
authors.affiliation: Internal Medicine Service, Hospital José Bernardo Iturraspe, Santa Fe, Argentina.
authors.forename: Franco
authors.initials: F
authors.lastname: Ferini
authors.affiliation: Internal Medicine Service, Hospital José Bernardo Iturraspe, Santa Fe, Argentina.
authors.forename: Luz
authors.initials: L
authors.lastname: Rodeles
authors.affiliation: Internal Medicine Service, Hospital José Bernardo Iturraspe, Santa Fe, Argentina.
authors.forename: Patricia
authors.initials: P
authors.lastname: Scholtus
authors.affiliation: Internal Medicine Service, Hospital José Bernardo Iturraspe, Santa Fe, Argentina.
authors.forename: Ana Karina
authors.initials: AK
authors.lastname: Long
authors.affiliation: Internal Medicine Service, Hospital José Bernardo Iturraspe, Santa Fe, Argentina.
authors.forename: Héctor Mario
authors.initials: HM
authors.lastname: Musacchio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000401:mortality; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000401:mortality*; D012372:ROC Curve; D011897:Random Allocation; D018570:Risk Assessment; D012720:Severity of Illness Index