Details

Autor(en) / Beteiligte

• Noguchi, Shingo
• Yatera, Kazuhiro
• Naito, Keisuke
• Hata, Ryosuke
• Kawanami, Toshinori
• Yamasaki, Kei
• Kato, Tatsuji
• Orihashi, Takeshi
• Inoue, Naoyuki
• Sakamoto, Noriho
• Yoshii, Chiharu
• Mukae, Hiroshi

Titel

Utility of the Quick Sequential Organ Failure Assessment in Japanese patients with nursing‐ and healthcare‐associated pneumonia

Ist Teil von

• Geriatrics & gerontology international, 2019-03, Vol.19 (3), p.177-183

Ort / Verlag

Kyoto, Japan: John Wiley & Sons Australia, Ltd

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Aim To clarify the utility of sepsis evaluation using the Quick Sequential Organ Failure Assessment (qSOFA) tool in addition to the Pneumonia Severity Index (PSI); age, dehydration, respiration, orientation and blood pressure (A‐DROP) index; and immunodeficiency, respiration, orientation, age and dehydration (I‐ROAD) scoring systems, and risk factor evaluation of potentially drug‐resistant (PDR) pathogens are suggested in the 2017 guidelines for pneumonia of the Japanese Respiratory Society in nursing‐ and healthcare‐associated pneumonia patients. Methods We included 289 hospitalized nursing‐ and healthcare‐associated pneumonia patients between April 2016 and March 2017, and investigated the ability of PSI, A‐DROP, I‐ROAD and qSOFA to predict pneumonia‐related mortality. We also evaluated the associations among the risk factors for PDR pathogens, the detection ratio of PDR pathogens and pneumonia‐related mortality. Results The mortality rate of pneumonia during hospitalization was 6.9% (20/289). The area under the curve for pneumonia‐related mortality predicted using PSI, A‐DROP, I‐ROAD and qSOFA was 0.697 (95% confidence interval [CI] 0.59–0.80), 0.63 (95% CI 0.51–0.76), 0.61 (95% CI 0.52–0.70) and 0.701 (95% CI 0.59–0.81), respectively. In addition, higher areas under the curve were observed for pneumonia‐related mortality predicted according to a combination of PSI and hypoalbuminemia (<2.5 g/dL) (0.75, 95% CI 0.64–0.86), and qSOFA and hypoalbuminemia (0.74, 95% CI 0.62–0.86) than for PSI and qSOFA alone. No significant associations were observed among the risk factors for PDR pathogens, the detection ratios of PDR pathogens and pneumonia‐related mortality. Conclusions qSOFA and the combination of qSOFA and hypoalbuminemia might be simple and useful evaluation tools for predicting pneumonia‐related mortality in nursing‐ and healthcare‐associated pneumonia patients. Geriatr Gerontol Int 2019; 19: 177–183.