Publication: A comparison of CURB65 and PSI scores in predicting outcomes for hospitalized bronchiectasis patient with community acquired pneumonia (CAP) in Hospital Sultanah Nurzahirah (HSNZ)
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Date
2021
Authors
Isa, Intan Aaroni Md
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Abstract
Background: Community Acquired Pneumonia is a common illness occur in the community however if not treated accordingly may cause morbidity and mortality. Bronchiectasis is a chronic lung disease in whom if developed pneumonia has a higher risk of mortality compared to those in general population. Hence the need for prompt recognition of bronchiectasis patients with CAP who are at increased risk for ICU admission and mortality. 2 commonly used scoring systems to assess severity of pneumonia are CURB65 and Pneumonia Severity Index (PSI). As bronchiectasis population is expected to increase in number and with higher mortality, it is important to detect CAP severity prediction directly upon admission in order to better assist in patient management. Therefore this study is made to compare these 2 scoring system, which one is better in predicting outcomes of hospitalized bronchiectasis patients with CAP. Methodology: This is a retrospective cohort study which was conducted in Hospital Sultanah Nur Zahirah (HSNZ) from May to August 2021 involving data from Jan 2010 till May 2021. 367 patients have been identified fulfilling inclusion and exclusion criteria after screening. CURB65 and PSI scores were calculated for each patients based on parameters taken upon admission. Demographic data were also recorded. Patients’ outcome which are the 30 days mortality and ICU admission were also identified. Data were analysed where the specificity, sensitivity, positive predictive value and negative predictive values were calculated for each score’s outcome. Comparison using ROC curve was made afterwards by heeding on the Area Under the Curve (AUC). Conclusion: In this study, PSI shown to be more sensitive to predict 30 days mortality and ICU admission for bronchiectasis patients who admitted for CAP compared to CURB65. However for specificity CURB65 is better. AUC of ROC curve did not show difference for both scores indicating that both are non-inferior to each other in terms of performance.
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