Comparison of severity scoring systems A‐DROP and CURB‐65 for community‐acquired pneumonia

Shindo, Yuichiro; Sato, Shinji; Maruyama, Eiichi; Ohashi, Taiki; Ogawa, Masahiro; Imaizumi, Kazuyoshi; Hasegawa, Yoshinori

doi:10.1111/j.1440-1843.2008.01329.x

Cited by 121 publications

(129 citation statements)

References 12 publications

Supporting

Mentioning

122

Contrasting

Order By: Relevance

“…Multivariate logistic regression was used to evaluate the impacts of hyponatremia and SIAD on the outcomes of interest. The following baseline risk factors associated with the severity of pneumonia in previous studies were considered for inclusion in the multivariate model [13][14][15] : age, gender, living in a care facility, use of a feeding tube, disorientation, systolic blood pressure <90 mmHg or diastolic blood pressure <60 mmHg, heart rate >125 beats/min, body temperature <35 C or >40 C, respiratory failure (defined as oxygen saturation 90% or partial pressure of oxygen 60 mmHg or respiratory rate >30 breaths/min), blood glucose >250 mg/dL, anemia (defined as hematocrit <30%), blood urea nitrogen (BUN) >20 mg/dL, serum C-reactive protein >10 mg/dL, serum albumin <3 g/dL, congestive heart failure, diabetes mellitus, chronic respiratory disease, malignancy, cirrhosis, chronic kidney failure, and central nervous system disease. The severity of pneumonia was evaluated by using the 6-point scale of the A-DROP (Age, Dehydration, Respiratory failure, Orientation disturbance, and low blood Pressure) scoring system proposed by the Japanese Respiratory Society.…”

Section: Methodsmentioning

confidence: 99%

“…The severity of pneumonia was evaluated by using the 6-point scale of the A-DROP (Age, Dehydration, Respiratory failure, Orientation disturbance, and low blood Pressure) scoring system proposed by the Japanese Respiratory Society. 15 This is a modified version of the CURB-65 (Confusion, Uremia, Respiratory rate, BP, age !65 years) clinical prediction rule and assesses the following parameters: age (men !70 years; women !75 years), dehydration (BUN concentration !21 mg/dL), respiratory failure (oxygen saturation 90%, partial pressure of oxygen 60 mmHg, ratio of partial pressure of oxygen to fraction of inspired oxygen 300), orientation disturbance (defined as disorientation at admission), and systolic blood pressure <90 mmHg. Patients with scores of 0 or 1 were classified as mild, patients scoring 2 as moderate, and patients scoring 3 to 5 as severe.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Impact of hyponatremia and the syndrome of inappropriate antidiuresis on mortality in elderly patients with aspiration pneumonia

Miyashita

Shimada

Hunter

et al. 2012

Journal of Hospital Medicine

View full text Add to dashboard Cite

BACKGROUND:Hyponatremia is associated with pneumonia, and aspiration pneumonia is common in the elderly, however, there has been no study of hyponatremia in this population.OBJECTIVE:To determine the impact of hyponatremia on mortality in elderly patients with aspiration pneumonia, while focusing on the comparison between those with and without the syndrome of inappropriate antidiuresis (SIAD).DESIGN:Retrospective review of existing database and medical records.SETTING:A community teaching hospital in Japan.PATIENTS:Two hundred and twenty‐one elderly patients hospitalized with aspiration pneumonia.MEASUREMENTS:Multivariate logistical regression models were used to compare 30‐day and in‐hospital mortality, in patients with hyponatremia of various severities and etiologies, with that in patients with normal serum sodium concentrations.RESULTS:Sixty‐five (29%) of 221 patients had hyponatremia. Of these 62 (95%) had hypotonic hyponatremia, which were further assessed as having hypovolemic (39 [63%]), hypervolemic (3 [5%]), and euvolemic (20 [32%]) hyponatremia. Of the 20 euvolemic patients, 14 (70%) had SIAD. Both moderate and severe hypotonic hyponatremia were significantly associated with increased in‐hospital mortality (odds ratio [OR] 6.05, 95% confidence interval [CI] 1.46–25.0, and OR 5.65, 95% CI 1.14–28.1, respectively). Hyponatremia due to SIAD was significantly associated with both increased 30‐day mortality (OR 7.40, 95% CI 1.73–31.7) and increased in‐hospital mortality (OR 22.3, 95% CI 4.26–117). In contrast, hypovolemic hyponatremia was not significantly associated with increased mortality.CONCLUSIONS:Hyponatremia due to SIAD was strongly associated with increased mortality in elderly patients with aspiration pneumonia, whereas hypovolemic hyponatremia was not associated with increased mortality. Journal of Hospital Medicine 2012;. © 2012 Society of Hospital Medicine

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Impact of hyponatremia and the syndrome of inappropriate antidiuresis on mortality in elderly patients with aspiration pneumonia

Miyashita

Shimada

Hunter

et al. 2012

Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…Patients are diagnosed with NHCAP when they met at least one of the following criteria: (1) having been admitted to the long-term care hospital or nursing home; (2) discharge from hospital in the preceding 90 days; (3) elder or physically disability people who need care (ECOG PS score ≥3); (4) outpatients who receive infusion therapy (including dialysis, antibiotics, anticancer agent, and immunosuppressant drug). Complications were defined as described previously [9][10][11][12][13].…”

Section: Definitionsmentioning

confidence: 99%

The definition of healthcare-associated pneumonia (HCAP) is insufficient for the medical environment in Japan: a comparison of HCAP and nursing and healthcare-associated pneumonia (NHCAP)

Kaku

Yanagihara

Morinaga

et al. 2013

Journal of Infection and Chemotherapy

View full text Add to dashboard Cite

Healthcare-associated pneumonia (HCAP) is a new concept of pneumonia, which was proposed in ATS/IDSA guidelines. The guidelines explain that HCAP patients should be treated with broad-spectrum antimicrobial drugs directed at multidrug-resistant (MDR)-pathogens. However, in Japan, there are many elderly people who received an in-home care service. They seemed to be consistent with the concept of HCAP, but they didn't meet the definition of HCAP. Therefore, the Japanese Respiratory Society modified the definition of HCAP according to medical environmental in Japan. We retrospectively observed HCAP patients and nursing and healthcare-associated pneumonia (NHCAP) patients who were hospitalized between 24 months at the Japanese Red Cross Nagasaki Genbaku Hospital (Nagasaki, Japan). Patient background, disease severity, identified pathogens, initial antibiotic regimens, and outcomes were compared. A total of 108 patients (77 HCAP and 31 NHCAP except HCAP patients) were evaluated. Of NHCAP except HCAP patients, 27 (87.1%) were over 3 in ECOG PS score. There were almost no significantly differences between two groups in the characteristics, pneumonia severity, identified bacteria, initial antibiotic regimens, and response rate of initial antibiotic therapy. Although the in-hospital mortality of HCAP patients and NHCAP except HCAP patients was 9.1% and 19.4%, respectively, this difference did not reach Kaku et al., Page 3 statistical significance (P>0.05). Our study suggested that, in the criteria of HCAP, some Japanese patients, who were consistent with the concept of HCAP, were classified into community-acquired pneumonia. Therefore, there is a need to change the definition of HCAP according to medical environment in Japan.

show abstract

“…There are several scoring systems used to evaluate the severity of community-acquired pneumonia, such as the pneumonia severity index (PSI), CURB65, and A-DROP [8][9][10]. PSI is a well-known but complex index that includes blood urea nitrogen and pleural effusion and is strongly influenced by dialysis.…”

Section: Introductionmentioning

confidence: 99%

“…PSI is a well-known but complex index that includes blood urea nitrogen and pleural effusion and is strongly influenced by dialysis. CURB65 and A-DROP also include blood urea nitrogen [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Modified A-DROP score and mortality in hemodialysis patients with pneumonia

et al. 2017

View full text Add to dashboard Cite

Background: Pneumonia is common in hemodialysis (HD) patients and has a poor prognosis, but there is little information on an accurate method for evaluating the severity of pneumonia, which is closely associated with prognosis, in HD patients. This study examined a method for evaluating the severity of pneumonia that was closely associated with 30-day mortality in HD patients. Methods: This was a retrospective observational study of 64 HD patients. We determined the relationship between the severity of pneumonia using a modified A-DROP (excluding the dehydration section) score and 30-day mortality. Results: Nine patients (14.1%) died and 40% of patients with an A-DROP score of 3 or 4 died within 30 days. Logistic regression analysis showed that the A-DROP score was significantly associated with 30-day mortality. The discriminatory ability of the A-DROP score was assessed using area under the receiver operating characteristic curve analysis (0.810; 95% confidence interval 0.653-0.967; p < 0.01).Conclusions: This modified A-DROP scoring system reflected the severity of pneumonia and was significantly associated with 30-day mortality. Patients with a modified A-DROP score of 3 or 4 had a poor prognosis.

show abstract

Comparison of severity scoring systems A‐DROP and CURB‐65 for community‐acquired pneumonia

Abstract: The JRS A-DROP can be used to assess severity of CAP, and gives similar results to CURB-65.

Cited by 121 publications

References 12 publications

Impact of hyponatremia and the syndrome of inappropriate antidiuresis on mortality in elderly patients with aspiration pneumonia

Impact of hyponatremia and the syndrome of inappropriate antidiuresis on mortality in elderly patients with aspiration pneumonia

The definition of healthcare-associated pneumonia (HCAP) is insufficient for the medical environment in Japan: a comparison of HCAP and nursing and healthcare-associated pneumonia (NHCAP)

Modified A-DROP score and mortality in hemodialysis patients with pneumonia

Contact Info

Product

Resources

About