Toplum kökenli pnömonili hastalarda pnömoni ciddiyet skorlamalarının karşılaştırılması
Comparing the scoring systems in community-acquired pneumonia
Yazar: FADİME DURAN YÜCESOY
Danışman: DOÇ. DR. AYŞE YILMAZ
Gaziosmanpaşa Üniversitesi / Tıp Fakültesi / Göğüs Hastalıkları Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2012
Konu: Göğüs Hastalıkları = Chest Diseases
Dizin: Mortalite = Mortality ; Pnömoni = Pneumonia ; Yoğun bakım üniteleri = Intensive care units ; Ölçekler = Scales

Özet:
ABSTRACTCURB-65, CRB-65, CURB, SOAR, rATS and Pneumonia Severity Index (PSI) are some of the scorings used to estimate complicated disease and mortality risks and to determine the need for treatment as inpatient or in intensive care unit in community-acquired pneumonia.The aim of the present study was to evaluate and compare different scoring methods such as CURB-65, CRB-65, CURB, SOAR, rATS and PSI in terms of their ability to predict the need for intensive care unit admission and mortality rates of CAP patients.In this investigation, a total of 70 CAP patients, applying to our hospital during January 2011-March 2012 period, were studied. Forty-one of them were male and 29 women. Their average age was 66,5 (21-88). Demographic features (age, sex, smoking and alcohol consumption history), additional diseases, physical examination findings, %SatO2, arterial blood gas analysis, laboratory and radiological data of the patients were retrospectively obtained. Need for intensive care unit admission and for mechanical ventilator was recorded in initial assessment. Patients were grouped into low and high risk groups based on CURB-65 CURB, CRB-65, rATS, SOAR and PSI scoring. Survival rate within one month of hospital discharge was obtained from hospital recording system.Thirty-one per cent of the patients were taken to intensive care unit. Thirty-day mortality rate after discharge from the hospital was %31,4. Of the patients died, 68% had been taken to intensive care unit and 31% had been treated as inpatient based on their first evaluations.Mortality rate was higher in patients with confusion. The need for intensive care unit admission was higher in the patients with cerebrovascular disease. Mortality rate of patients taken to intensive care unit was 68%. Blood urea nitrogen was higher in patients who were taken to intensive care unit and who died.In all scoring systems, need for intensive care and mortality rate was higher in higher grades assigned to patients. Mortality rates were high in high risk groups in scoring systems except for PSI. The patients in high risk group based on the scoring systems other than SOAR and PSI had higher need for intensive care. CURB-65, CURB and CRB-65 scorings were the ones that could best predict the need for intensive care unit admission and mortality (Table 1 and 2).CURB-65, CURB and CRB-65 scorings are the systems that can be used for prediction of the need for the transfer to intensive care unit and the mortality.Key Words: Community-Acquired Pneumonia, CURB-65, CURB, CRB-65, rATS, SOAR, PSI

Abstract:
ABSTRACTCURB-65, CRB-65, CURB, SOAR, rATS and Pneumonia Severity Index (PSI) are some of the scorings used to estimate complicated disease and mortality risks and to determine the need for treatment as inpatient or in intensive care unit in community-acquired pneumonia.The aim of the present study was to evaluate and compare different scoring methods such as CURB-65, CRB-65, CURB, SOAR, rATS and PSI in terms of their ability to predict the need for intensive care unit admission and mortality rates of CAP patients.In this investigation, a total of 70 CAP patients, applying to our hospital during January 2011-March 2012 period, were studied. Forty-one of them were male and 29 women. Their average age was 66,5 (21-88). Demographic features (age, sex, smoking and alcohol consumption history), additional diseases, physical examination findings, %SatO2, arterial blood gas analysis, laboratory and radiological data of the patients were retrospectively obtained. Need for intensive care unit admission and for mechanical ventilator was recorded in initial assessment. Patients were grouped into low and high risk groups based on CURB-65 CURB, CRB-65, rATS, SOAR and PSI scoring. Survival rate within one month of hospital discharge was obtained from hospital recording system.Thirty-one per cent of the patients were taken to intensive care unit. Thirty-day mortality rate after discharge from the hospital was %31,4. Of the patients died, 68% had been taken to intensive care unit and 31% had been treated as inpatient based on their first evaluations.Mortality rate was higher in patients with confusion. The need for intensive care unit admission was higher in the patients with cerebrovascular disease. Mortality rate of patients taken to intensive care unit was 68%. Blood urea nitrogen was higher in patients who were taken to intensive care unit and who died.In all scoring systems, need for intensive care and mortality rate was higher in higher grades assigned to patients. Mortality rates were high in high risk groups in scoring systems except for PSI. The patients in high risk group based on the scoring systems other than SOAR and PSI had higher need for intensive care. CURB-65, CURB and CRB-65 scorings were the ones that could best predict the need for intensive care unit admission and mortality (Table 1 and 2).CURB-65, CURB and CRB-65 scorings are the systems that can be used for prediction of the need for the transfer to intensive care unit and the mortality.Key Words: Community-Acquired Pneumonia, CURB-65, CURB, CRB-65, rATS, SOAR, PSI