Background: No mortality prediction rule is suited for non-elderly patients with community-acquired pneumonia. Therefore, we tried to create a mortality prediction rule that is simple and suitable for non-elderly patients with community-acquired pneumonia. Methods: Because of low mortality at young age, we used information from an administrative database that included A-DROP data. We analysed the rate and risk factors for in-hospital community-acquired pneumonia-associated death among non-elderly patients and created a mortality prediction rule based on those risk factors. Results: We examined 49,370 hospitalisations for patients aged 18-64 years with community-acquired pneumonia. The 30-day fatality rate was 1.5 %. Using regression analysis, five risk factors were selected: patient requires help for feeding, the existence of malignancy, confusion, low blood pressure, and age 40-64 years. Each risk factor of our proposed mortality risk scoring system received one point. A total point score for each patient was obtained by summing the points. The negative likelihood ratio for the score 0 group was 0.01, and the positive likelihood ratio for the score ≥4 group was 19.9. The area under the curve of the risk score for non-elderly (0.86, 95 % confidence interval: 0.84-0.87) was higher than that of the A-DROP score (0.72, 95 % confidence interval: 0.70-0.74) (P < 0.0001). Conclusions: Our newly proposed mortality risk scoring system may be appropriate for predicting mortality in non-elderly patients with community-acquired pneumonia. It showed a possibility of a better prediction value than the A-DROP and is easy to use in various clinical settings.
CITATION STYLE
Tashiro, M., Fushimi, K., Takazono, T., Kurihara, S., Miyazaki, T., Tsukamoto, M., … Izumikawa, K. (2016). A mortality prediction rule for non-elderly patients with community-acquired pneumonia. BMC Pulmonary Medicine, 16(1). https://doi.org/10.1186/s12890-016-0199-z
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