Severity prediction rules in community acquired pneumonia: a validation study

• Published in: Thorax 2000-03, Vol.55 (3), p.219-223
• Main Authors: Lim, W S, Lewis, S, Macfarlane, J T
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Aged; Aged, 80 and over; Antibiotics; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Case-Control Studies; community acquired pneumonia; Community-Acquired Infections - mortality; Hemoglobin; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Mortality; Multivariate Analysis; Original; Oxygen saturation; Pathogens; Pneumonia; Pneumonia - mortality; Practice Guidelines as Topic; prediction rule; Predictive Value of Tests; Regression analysis; Risk Factors; severity; Severity of Illness Index; Statistical significance; Streptococcus infections
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax.55.3.219

BACKGROUND The British Thoracic Society (BTS) developed a rule (BTSr) based on severity criteria to predict short term mortality in adults admitted to hospital with community acquired pneumonia (CAP). However, neither the BTSr nor a recent modification of it (mBTSr) have been validated in the UK. A case-control study was conducted in a typical UK population to determine the clinical factors predictive of mortality and to assess the performance of these rules. METHODS Cases were drawn from all patients with CAP who died in 1997 in five large hospitals in the Mid Trent area. Controls were randomly selected from survivors. Factors associated with mortality were identified following review of medical case notes and performance of the severity prediction rules assessed. RESULTS Age >65 years, temperature 24 breaths/min, mental confusion, urea concentration of >7 mmol/l, sodium concentration of