Viral prevalence, clinical profiles and comparison of severity scores for predicting the mortality of adults with severe acute respiratory infections

Abstract

Background/aim: The aim of this study was to determine the accuracy of severity scores for predicting the 28-day mortality among adults with severe acute respiratory infection (SARI) admitted to the emergency department. Materials and methods:This study included 159 consecutive adult patients with SARI admitted to the emergency department of a tertiary hospital. A standard form was filled out in order to record demographic information, clinical parameters, laboratory tests, and radiographic findings of the patients. CURB-65, PSI, SIRS, qSOFA, SOFA and APACHE II scores were compared between the survivor and nonsurvivor groups.Results: Of 159 patients included in the study, 38.4% were positive for respiratory viruses and 28.3% were positive for influenza viruses. 35.8% of the patients were admitted to an intensive care unit (ICU) and the mortality rate was 36.5%. The area under the receiver operating characteristic curve of CURB-65, PSI, SIRS criteria, qSOFA, SOFA and APACHE II scores were 0.717, 0.712, 0.607, 0.683, 0.755, and 0.748, respectively in predicting mortality and 0.759, 0.744, 0.583, 0.728, 0.741, and 0.731, respectively in predicting ICU admission.Conclusion: SOFA and APACHE II were more accurate than SIRS in predicting the 28-day mortality among adults with SARI. There was no significant difference among these scores in terms of other multivariate comparisons.

Performance of established disease severity scores in predicting severe outcomes among adults hospitalized with influenza—FluSurv‐NET, 2017–2018

“…ICU admission [15], and mortality [16][17][18][19][20]. Interestingly, the PSI has been previously shown to perform relatively well compared to other pneumonia severity scores for predicting influenza-related mortality [19], similar to our findings in this study.…”

“…Previous studies have assessed the performance of scores in predicting outcomes related to respiratory viruses, including influenza, reviewed by Adams et al [ 13 ]. In general, indices validated against community‐acquired pneumonia have demonstrated poor discrimination (ROC area ≤ 0.7) for influenza‐related outcomes, including the need for hospital admission [ 14 ], need for a higher level of care [ 12 ], ICU admission [ 15 ], and mortality [ 16 , 17 , 18 , 19 , 20 ]. Interestingly, the PSI has been previously shown to perform relatively well compared to other pneumonia severity scores for predicting influenza‐related mortality [ 19 ], similar to our findings in this study.…”

The Battle of the Pneumonia Predictors: A Comprehensive Meta-Analysis Comparing the Pneumonia Severity Index (PSI) and the CURB-65 Score in Predicting Mortality and the Need for ICU Support

“… Alavi-Moghaddam et al, 2013 [ 20 ], Ozkan et al, 2020 [ 21 ], Fuchs Bahlis et al, 2021 [ 2 ], Esteban Ronda et al, 2021 [ 22 ], Feng et al, 2021 [ 3 ], Lazar Neto et al, 2021 [ 6 ], Estella, 2015 [ 23 ], Demirel, 2018 [ 24 ], Holten et al, 2020 [ 25 ], Olivia et al, 2021 [ 26 ], Cupurdija et al, 2015 [ 27 ], Anurag and Preetam, 2021 [ 5 ], Ranzani et al, 2017 [ 28 ], Günaydın et al, 2019 [ 29 ], Tsai et al, 2021 [ 30 ], Wen et al, 2020 [ 31 ], Putot et al, 2016 [ 7 ], Wang et al, 2020 [ 32 ], Bloom et al, 2019 [ 33 ], Williams et al, 2018 [ 34 ], Kim et al, 2013 [ 10 ], Aydin et al, 2019 [ 35 ], Akpınar et al, 2019 [ 36 ], Ito et al, 2017 [ 37 ], Lee et al, 2013 [ 38 ] …”

“…The remaining five articles [ 2 , 10 , 23 , 32 , 35 ] were compared for mortality rates in the lowest classes; class I-II and class 0-1 for PSI and CURB 65, respectively. Bahlis et al [ 2 ] had 3.7%/4.5%, Estella [ 23 ] 20%/13.3%, Wang et al [ 32 ] 8.1%/5.1%, Kim et al [ 10 ] 4.5%/2.3%, and Aydin et al [ 35 ] 8.6%/10.0% mortality rates by PSI and CURB 65 prediction, respectively. The range for mortality rate in PSI scores was 3.7-24.9%.…”

“… Fuchs Bahlis et al, 2021 [ 2 ], Estella, 2015 [ 23 ], Wang et al, 2020 [ 32 ], Kim et al, 2013 [ 10 ], Aydin et al, 2019 [ 35 ] …”