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FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients.

ABSTRACT: BACKGROUND:The pneumonia severity index (PSI) and the CURB-65 (confusion, urea, respiratory rate, blood pressure, age???65?years) score have been shown to predict mortality in community-acquired pneumonia. Their ability to predict influenza-related pneumonia, however, is less well-established. METHODS:A total of 693 laboratory-confirmed FluA-p patients diagnosed between Jan 2013 and Dec 2018 and recruited from five teaching hospitals in China were included in the study. The sample included 494 patients in the derivation cohort and 199 patients in the validation cohort. The prediction rule was established based on independent risk factors for 30-day mortality in FluA-p patients from the derivation cohort. RESULTS:The 30-day mortality of FluA-p patients was 19.6% (136/693). The FluA-p score was based on a multivariate logistic regression model designed to predict mortality. Results indicated the following significant predictors (regression statistics and point contributions toward total score in parentheses): blood urea nitrogen >?7?mmol/L (OR 1.604, 95% CI 1.150-4.492, p?=?0.040; 1 points), pO2/FiO2???250?mmHg (OR 2.649, 95% CI 1.103-5.142, p?=?0.022; 2 points), cardiovascular disease (OR 3.967, 95% CI 1.269-7.322, p?

SUBMITTER: Chen L

PROVIDER: S-EPMC7206684 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients.

Chen Liang L Han Xiudi X Li Yan Li YL Zhang Chunxiao C Xing Xiqian X

Respiratory research 20200508 1

<h4>Background</h4>The pneumonia severity index (PSI) and the CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥ 65 years) score have been shown to predict mortality in community-acquired pneumonia. Their ability to predict influenza-related pneumonia, however, is less well-established.<h4>Methods</h4>A total of 693 laboratory-confirmed FluA-p patients diagnosed between Jan 2013 and Dec 2018 and recruited from five teaching hospitals in China were included in the study. The sample ...[more]

PMID: 32384935

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Project description:BackgroundRespiratory viruses are important etiologies of community-acquired pneumonia. However, current knowledge on the prognosis of respiratory virus-related pneumonia (RV-p) is limited. Thus, here we aimed to establish a clinical predictive model for mortality of patients with RV-p.MethodsA total of 1431 laboratory-confirmed patients with RV-p, including 1169 and 262 patients from respective derivation and validation cohorts from five teaching hospitals in China were assessed between January 2010 and December 2019. A prediction rule was established on the basis of risk factors for 30-day mortality of patients with RV-p from the derivation cohort using a multivariate logistic regression model.ResultsThe 30-day mortality of patients with RV-p was 16.8% (241/1431). The RV-p score was composed of nine predictors (including respective points of mortality risk): (a) age ⩾65 years (1 point); (b) chronic obstructive pulmonary disease (1 point); (c) mental confusion (1 point); (d) blood urea nitrogen (1 point); (e) cardiovascular disease (2 points); (f) smoking history (2 points); (g) arterial pressure of oxygen/fraction of inspiration oxygen (PaO2/FiO2) < 250 mmHg (2 points); (h) lymphocyte counts <0.8 × 109/L (2 points); (i) arterial PH < 7.35 (3 points). A total of six points was used as the cut-off value for mortality risk stratification. Our model showed a sensitivity of 0.831 and a specificity of 0.783. The area under the receiver operating characteristic curve was more prominent for RV-p scoring [0.867, 95% confidence interval (CI)0.846-0.886] when compared with both pneumonia severity index risk (0.595, 95% CI 0.566-0.624, p < 0.001) and CURB-65 scoring (0.739, 95% CI 0.713-0.765, p < 0.001).ConclusionRV-p scoring was able to provide a good predictive accuracy for 30-day mortality, which accounted for a more effective stratification of patients with RV-p into relevant risk categories and, consequently, help physicians to make more rational clinical decisions.The reviews of this paper are available via the supplemental material section.

Dataset Information

FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients.

Publications

FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients.

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