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肺炎の重症度スコア(CRB-65)

※A-DROP:(表[ID0601])
出典
imgimg
1: Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study.
著者: Lim WS, van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI, Lewis SA, Macfarlane JT.
雑誌名: Thorax. 2003 May;58(5):377-82. doi: 10.1136/thorax.58.5.377.
Abstract/Text: BACKGROUND: In the assessment of severity in community acquired pneumonia (CAP), the modified British Thoracic Society (mBTS) rule identifies patients with severe pneumonia but not patients who might be suitable for home management. A multicentre study was conducted to derive and validate a practical severity assessment model for stratifying adults hospitalised with CAP into different management groups.
METHODS: Data from three prospective studies of CAP conducted in the UK, New Zealand, and the Netherlands were combined. A derivation cohort comprising 80% of the data was used to develop the model. Prognostic variables were identified using multiple logistic regression with 30 day mortality as the outcome measure. The final model was tested against the validation cohort.
RESULTS: 1068 patients were studied (mean age 64 years, 51.5% male, 30 day mortality 9%). Age >/=65 years (OR 3.5, 95% CI 1.6 to 8.0) and albumin <30 g/dl (OR 4.7, 95% CI 2.5 to 8.7) were independently associated with mortality over and above the mBTS rule (OR 5.2, 95% CI 2.7 to 10). A six point score, one point for each of Confusion, Urea >7 mmol/l, Respiratory rate >/=30/min, low systolic(<90 mm Hg) or diastolic (/=65 years (CURB-65 score) based on information available at initial hospital assessment, enabled patients to be stratified according to increasing risk of mortality: score 0, 0.7%; score 1, 3.2%; score 2, 3%; score 3, 17%; score 4, 41.5% and score 5, 57%. The validation cohort confirmed a similar pattern.
CONCLUSIONS: A simple six point score based on confusion, urea, respiratory rate, blood pressure, and age can be used to stratify patients with CAP into different management groups.
Thorax. 2003 May;58(5):377-82. doi: 10.1136/thorax.58.5.377.

A-DROP

市中肺炎を外来あるいは入院で治療するかどうかの指標
出典
imgimg
1: Comparison of severity scoring systems A-DROP and CURB-65 for community-acquired pneumonia.
著者: Shindo Y, Sato S, Maruyama E, Ohashi T, Ogawa M, Imaizumi K, Hasegawa Y.
雑誌名: Respirology. 2008 Sep;13(5):731-5. doi: 10.1111/j.1440-1843.2008.01329.x.
Abstract/Text: BACKGROUND AND OBJECTIVE: The initial assessment of the severity of community-acquired pneumonia (CAP) is important for patient management. The Japanese Respiratory Society (JRS) has proposed a 6-point scale (0-5) to assess the clinical severity of CAP. The A-DROP scoring system assesses the following parameters: (i) Age (male >or= 70 years, female >or= 75 years); (ii) Dehydration (blood urea nitrogen (BUN) >or= 210 mg/L); (iii) Respiratory failure (SaO(2) 7 mmol/L (200 mg/L), respiratory rate >or= 30/min, low blood pressure (diastolic or= 65 years) proposed by the British Thoracic Society. However, validation of A-DROP has not been attempted nor has it been compared with CURB-65. The aim of this study was to confirm that A-DROP is equivalent to CURB-65 for predicting severity of CAP.
METHODS: A retrospective observational study was conducted of patients with CAP hospitalized at a single centre between November 2005 and January 2007. The 30-day mortality after admission was compared following assessment of severity using the A-DROP and CURB-65 scoring systems.
RESULTS: Three-hundred and twenty-nine patients were evaluated. The areas under the receiver operating characteristic curves were 0.846 (95% confidence interval (CI): 0.790-0.903) and 0.835 (95% CI: 0.763-0.908) for A-DROP and CURB-65, respectively.
CONCLUSION: The JRS A-DROP can be used to assess severity of CAP, and gives similar results to CURB-65.
Respirology. 2008 Sep;13(5):731-5. doi: 10.1111/j.1440-1843.2008.01329...

PORT severity index(PSI)による重症度分類

参考文献:
Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, Coley CM, Marrie TJ, Kapoor WN.: A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997 Jan 23;336(4):243-50.
出典
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1: 著者提供

肺炎の重症度スコア(CURB-65)

出典
imgimg
1: Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study.
著者: Lim WS, van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI, Lewis SA, Macfarlane JT.
雑誌名: Thorax. 2003 May;58(5):377-82. doi: 10.1136/thorax.58.5.377.
Abstract/Text: BACKGROUND: In the assessment of severity in community acquired pneumonia (CAP), the modified British Thoracic Society (mBTS) rule identifies patients with severe pneumonia but not patients who might be suitable for home management. A multicentre study was conducted to derive and validate a practical severity assessment model for stratifying adults hospitalised with CAP into different management groups.
METHODS: Data from three prospective studies of CAP conducted in the UK, New Zealand, and the Netherlands were combined. A derivation cohort comprising 80% of the data was used to develop the model. Prognostic variables were identified using multiple logistic regression with 30 day mortality as the outcome measure. The final model was tested against the validation cohort.
RESULTS: 1068 patients were studied (mean age 64 years, 51.5% male, 30 day mortality 9%). Age >/=65 years (OR 3.5, 95% CI 1.6 to 8.0) and albumin <30 g/dl (OR 4.7, 95% CI 2.5 to 8.7) were independently associated with mortality over and above the mBTS rule (OR 5.2, 95% CI 2.7 to 10). A six point score, one point for each of Confusion, Urea >7 mmol/l, Respiratory rate >/=30/min, low systolic(<90 mm Hg) or diastolic (/=65 years (CURB-65 score) based on information available at initial hospital assessment, enabled patients to be stratified according to increasing risk of mortality: score 0, 0.7%; score 1, 3.2%; score 2, 3%; score 3, 17%; score 4, 41.5% and score 5, 57%. The validation cohort confirmed a similar pattern.
CONCLUSIONS: A simple six point score based on confusion, urea, respiratory rate, blood pressure, and age can be used to stratify patients with CAP into different management groups.
Thorax. 2003 May;58(5):377-82. doi: 10.1136/thorax.58.5.377.

肺炎の重症度スコア(CRB-65)

※A-DROP:(表[ID0601])
出典
imgimg
1: Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study.
著者: Lim WS, van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI, Lewis SA, Macfarlane JT.
雑誌名: Thorax. 2003 May;58(5):377-82. doi: 10.1136/thorax.58.5.377.
Abstract/Text: BACKGROUND: In the assessment of severity in community acquired pneumonia (CAP), the modified British Thoracic Society (mBTS) rule identifies patients with severe pneumonia but not patients who might be suitable for home management. A multicentre study was conducted to derive and validate a practical severity assessment model for stratifying adults hospitalised with CAP into different management groups.
METHODS: Data from three prospective studies of CAP conducted in the UK, New Zealand, and the Netherlands were combined. A derivation cohort comprising 80% of the data was used to develop the model. Prognostic variables were identified using multiple logistic regression with 30 day mortality as the outcome measure. The final model was tested against the validation cohort.
RESULTS: 1068 patients were studied (mean age 64 years, 51.5% male, 30 day mortality 9%). Age >/=65 years (OR 3.5, 95% CI 1.6 to 8.0) and albumin <30 g/dl (OR 4.7, 95% CI 2.5 to 8.7) were independently associated with mortality over and above the mBTS rule (OR 5.2, 95% CI 2.7 to 10). A six point score, one point for each of Confusion, Urea >7 mmol/l, Respiratory rate >/=30/min, low systolic(<90 mm Hg) or diastolic (/=65 years (CURB-65 score) based on information available at initial hospital assessment, enabled patients to be stratified according to increasing risk of mortality: score 0, 0.7%; score 1, 3.2%; score 2, 3%; score 3, 17%; score 4, 41.5% and score 5, 57%. The validation cohort confirmed a similar pattern.
CONCLUSIONS: A simple six point score based on confusion, urea, respiratory rate, blood pressure, and age can be used to stratify patients with CAP into different management groups.
Thorax. 2003 May;58(5):377-82. doi: 10.1136/thorax.58.5.377.

A-DROP

市中肺炎を外来あるいは入院で治療するかどうかの指標
出典
imgimg
1: Comparison of severity scoring systems A-DROP and CURB-65 for community-acquired pneumonia.
著者: Shindo Y, Sato S, Maruyama E, Ohashi T, Ogawa M, Imaizumi K, Hasegawa Y.
雑誌名: Respirology. 2008 Sep;13(5):731-5. doi: 10.1111/j.1440-1843.2008.01329.x.
Abstract/Text: BACKGROUND AND OBJECTIVE: The initial assessment of the severity of community-acquired pneumonia (CAP) is important for patient management. The Japanese Respiratory Society (JRS) has proposed a 6-point scale (0-5) to assess the clinical severity of CAP. The A-DROP scoring system assesses the following parameters: (i) Age (male >or= 70 years, female >or= 75 years); (ii) Dehydration (blood urea nitrogen (BUN) >or= 210 mg/L); (iii) Respiratory failure (SaO(2) 7 mmol/L (200 mg/L), respiratory rate >or= 30/min, low blood pressure (diastolic or= 65 years) proposed by the British Thoracic Society. However, validation of A-DROP has not been attempted nor has it been compared with CURB-65. The aim of this study was to confirm that A-DROP is equivalent to CURB-65 for predicting severity of CAP.
METHODS: A retrospective observational study was conducted of patients with CAP hospitalized at a single centre between November 2005 and January 2007. The 30-day mortality after admission was compared following assessment of severity using the A-DROP and CURB-65 scoring systems.
RESULTS: Three-hundred and twenty-nine patients were evaluated. The areas under the receiver operating characteristic curves were 0.846 (95% confidence interval (CI): 0.790-0.903) and 0.835 (95% CI: 0.763-0.908) for A-DROP and CURB-65, respectively.
CONCLUSION: The JRS A-DROP can be used to assess severity of CAP, and gives similar results to CURB-65.
Respirology. 2008 Sep;13(5):731-5. doi: 10.1111/j.1440-1843.2008.01329...