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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Severity of illness scoring systems in patients with bacteraemic pneumococcal pneumonia: Implications for the intensive care unit care
Clinical Microbiology and Infection, Volume 15, No. 9, Year 2009
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Description
Severity of illness scoring systems are useful for decisions on the management of patients with community-acquired pneumonia (CAP), including assessing the need for intensified therapy and monitoring, or for intensive care unit (ICU) admission. We compared the accuracy of the Pneumonia Severity Index (PSI), the CURB-65 and CRB-65 score, the modified-American Thoracic Society score (ATS), the IDSA/ATS guidelines and the Pitt Bacteraemia score (PBS) in evaluating severity of illness in 766 patients with bacteraemic pneumococcal pneumonia. We evaluated the sensitivity and specificity, the positive predictive value (PPV) and the negative predictive value (NPV) and the accuracy of the classification in predicting 14-day mortality. The PSI and the IDSA/ATS guidelines were the most sensitive whereas the PBS and modified-ATS scoring systems were the most specific in predicting mortality. The NPV was comparable for all four scoring systems (all above 90%), but the PPV was highest for PBS (54.2%) and lowest for PSI (23.2%). The predictive accuracy and discriminating power as measured by the receiver-operating characteristic (ROC) curve was highest for the PBS. Both the modified-ATS and the PBS scoring systems identified those patients who might benefit most from intensified care and monitoring. The PBS and modified-ATS proved superior to the IDSA/ATS guidelines, CURB-65 and CRB-65 with respect to their specificity and PPV. The low PPV of the PSI rendered it not usable as a parameter for decision-making in severely-ill patients with pneumococcal bacteraemia. © Journal compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases.
Authors & Co-Authors
Feldman, Charles
South Africa, Johannesburg
University of the Witwatersrand
South Africa, Johannesburg
Charlotte Maxeke Johannesburg Academic Hospital
Alanee, S. R.J.
United States, Atlanta
Rollins School of Public Health
South Africa, Johannesburg
University of the Witwatersrand
Yu, Victor L.
United States, Pittsburgh
University of Pittsburgh School of Medicine
United States, Pittsburgh
University of Pittsburgh
Richards, Guy Antony
South Africa, Johannesburg
University of the Witwatersrand
Ortqvist, A.
Sweden, Stockholm
Region Stockholm
Sweden, Stockholm
Karolinska Universitetssjukhuset
Rello, Jordi
Spain, Tarragona
Universitat Rovira I Virgili
Spain, Tarragona
Hospital Universitario Joan Xxiii de Tarragona
Chiou, Christine Chia Christine
United States, Pittsburgh
University of Pittsburgh School of Medicine
Chedid, Maria Bernadete F.
Brazil, Porto Alegre
Universidade Federal de Ciencias da Saúde de Porto Alegre
Wagener, Marilyn M.
United States, Pittsburgh
University of Pittsburgh School of Medicine
Klugman, K. P.
United States, Atlanta
Rollins School of Public Health
South Africa, Johannesburg
University of the Witwatersrand
South Africa, Johannesburg
Charlotte Maxeke Johannesburg Academic Hospital
Luna, Carlos Marcelo
Argentina, Porto
Hospital de Clinicas
Mosquera, Ricardo
Argentina, Porto
Hospital de Clinicas
de Mier, Carmen A.
Argentina, Porto
Hospital de Clinicas
Famiglietti, Ángela María Rosa
Argentina, Porto
Hospital de Clinicas
Vay, Carlos Alberto
Argentina, Porto
Hospital de Clinicas
Gentile, Jorge H.
Argentina, Sao Paulo
Hospital Santmarina
Sparo, Mónica D.
Argentina, Sao Paulo
Hospital Santmarina
Dias, Cicero
Brazil, Porto Alegre
Universidade Federal de Ciencias da Saúde de Porto Alegre
Barth, Afonso Luís
Brazil, Porto Alegre
Hospital de Clinicas de Porto Alegre
Dos Santos, Breno Riegel
Brazil, Porto Alegre
Hospital Criança Conceição
Andremont, Antoine O.
France, Paris
Hôpital Bichat-claude-bernard Ap-hp
Grenet, Karine
France, Paris
Hôpital Bichat-claude-bernard Ap-hp
Pharm, D.
France, Paris
Hôpital Bichat-claude-bernard Ap-hp
Spain, Tarragona
Hospital Universitario Joan Xxiii de Tarragona
Mounieme, Hyam
France, Paris
Hôpital Bichat-claude-bernard Ap-hp
Hui, David Shu Cheong
Hong Kong, Hong Kong
Chinese University of Hong Kong
Ip, Margaret P.Y.
Hong Kong, Hong Kong
Chinese University of Hong Kong
Lyon, Donald J.
Hong Kong, Hong Kong
Chinese University of Hong Kong
Morris, Arthur James
New Zealand, Auckland
Auckland City Hospital
Roberts, Sally A.
New Zealand, Auckland
Auckland City Hospital
Drinković, Dragana
New Zealand, Auckland
Auckland City Hospital
Taylor, Susan L.
New Zealand, Auckland
Auckland City Hospital
van Gottberg, Anne
South Africa, Johannesburg
Charlotte Maxeke Johannesburg Academic Hospital
Poswa, Xoliswa
South Africa, Johannesburg
Charlotte Maxeke Johannesburg Academic Hospital
Morar, Rajen
South Africa, Johannesburg
Charlotte Maxeke Johannesburg Academic Hospital
Gallego, Miguel Ángel González
Spain, Tarragona
Hospital Universitario Joan Xxiii de Tarragona
Lujàn, Manel
Spain, Tarragona
Hospital Universitario Joan Xxiii de Tarragona
Díaz, Emili
Spain, Tarragona
Hospital Universitario Joan Xxiii de Tarragona
Mariscal, Dolors
Spain, Tarragona
Hospital Universitario Joan Xxiii de Tarragona
Fontanals, Dionísia Dionisia
Spain, Tarragona
Hospital Universitario Joan Xxiii de Tarragona
Santamaría, Josep María
Spain, Tarragona
Hospital Universitario Joan Xxiii de Tarragona
Rylander, Margareta
Sweden, Stockholm
Karolinska Universitetssjukhuset
Chang, Feng Yee
Taiwan, Taipei
Triservice General Hospital Taiwan
Ko, Wen Chien
Taiwan, Tainan
National Cheng Kung University Hospital
Wu, Wenpin
Taiwan, Martin
St. Martin de Porres Hospital
Yi, Chia
Taiwan, Martin
St. Martin de Porres Hospital
Snydman, David R.
United States, Boston
Tufts Medical Center
Barefoot, Laurie A.
United States, Boston
Tufts Medical Center
McDermott, Laura A.
United States, Boston
Tufts Medical Center
Blazes, David L.
United States, Bethesda
Walter Reed National Military Medical Center
Marin, Gregory
United States, Bethesda
Walter Reed National Military Medical Center
Baddour, Larry M.
United States, Knoxville
University of Tennessee Medical Center
Mobasseri, Mandana
United States, Knoxville
University of Tennessee Medical Center
Kim, Dong Hoon Daniel
United States, Pittsburgh
University of Pittsburgh
Rihs, John D.
United States, Pittsburgh
University of Pittsburgh
Statistics
Citations: 65
Authors: 54
Affiliations: 23
Identifiers
Doi:
10.1111/j.1469-0691.2009.02901.x
ISSN:
1198743X
e-ISSN:
14690691