Risk Prediction Models for Mortality in Community-Acquired Pneumonia: A Systematic Review

被引:33
作者
Kwok, Chun Shing [1 ]
Loke, Yoon K. [1 ,2 ]
Woo, Kenneth [2 ]
Myint, Phyo Kyaw [3 ]
机构
[1] Norfolk & Norwich Univ Hosp, Norwich NR4 7UY, Norfolk, England
[2] Univ E Anglia, Norwich Med Sch, Norwich NR4 7TJ, Norfolk, England
[3] Univ Aberdeen, Sch Med & Dent, Div Appl Hlth Sci, Aberdeen AB25 2ZD, Scotland
关键词
SEVERITY ASSESSMENT; EMERGENCY PHYSICIANS; VALIDATION; RULE; MANAGEMENT; CRITERIA; OUTCOMES; CURB-65; INDEX; CARE;
D O I
10.1155/2013/504136
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
Background. Several models have been developed to predict the risk of mortality in community-acquired pneumonia (CAP). This study aims to systematically identify and evaluate the performance of published risk prediction models for CAP. Methods. We searched MEDLINE, EMBASE, and Cochrane library in November 2011 for initial derivation and validation studies for models which predict pneumonia mortality. We aimed to present the comparative usefulness of their mortality prediction. Results. We identified 20 different published risk prediction models for mortality in CAP. Four models relied on clinical variables that could be assessed in community settings, with the two validated models BTS1 and CRB-65 showing fairly similar balanced accuracy levels (0.77 and 0.72, resp.), while CRB-65 had AUROC of 0.78. Nine models required laboratory tests in addition to clinical variables, and the best performance levels amongst the validated models were those of CURB and CURB-65 (balanced accuracy 0.73 and 0.71, resp.), with CURB-65 having an AUROC of 0.79. The PSI (AUROC 0.82) was the only validated model with good discriminative ability among the four that relied on clinical, laboratorial, and radiological variables. Conclusions. There is no convincing evidence that other risk prediction models improve upon the well-established CURB-65 and PSI models.
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页数:12
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