Value of the pneumonia severity index in assessment of community-acquired pneumonia
Lin, C-Chung.; Lee, C-Hung.; Chen, C-Zuei.; Chu, Y-Chin.; Hung, T-Jen.; Chang, H-Yu.; Hsiue, T-Ren.
Journal of the Formosan Medical Association 104(3): 164-167
2005
ISSN/ISBN: 0929-6646 PMID: 15818429 Document Number: 590561
Background and Purpose: The value of the Pneumonia Severity Index (PSI) in predicting the mortality of patients with community-acquired pneumonia has not been reported in Taiwan. This study investigated the value of this scoring system in estimating mortality of inpatients with community-acquired pneumonia.Methods. This was a prospective observational study of 118 inpatients and a retrospective chart review of 115 inpatients with radiographically-confirmed community-acquired pneumonia treated at a tertiary referral medical center in southern Taiwan. Patients were stratified into 5 risk classes according to PSI score. Data on demographic characteristics, comorbidities, baseline clinical and laboratory features, in-hospital mortality and length of hospital stay were analyzed.Results: The mortality rates according to risk classification were 0% for class I and II, 2.5% for class III, 8.2% for class IV, and 31.2% for class V. A significant correlation was found between these risk classes and medical outcome (p < 0.001). The length of hospital stay was significantly associated with risk class, and ranged from 6.3 days for class I patients to 18 days for class V (p < 0.001).Conclusion: The PSI provided a useful prediction of medical outcome in patients with community-acquired pneumonia. To decrease unnecessary admission, further prospective studies are needed to determine whether outpatient therapy is appropriate for class I or class II patients with community-acquired pneumonia.