Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
Prediction model for mortality in cancer patients with pneumonia: comparison with CURB‐65 and PSI
Ist Teil von
The clinical respiratory journal, 2018-02, Vol.12 (2), p.538-546
Ort / Verlag
England: Wiley Subscription Services, Inc
Erscheinungsjahr
2018
Link zum Volltext
Quelle
Wiley Online Library - AutoHoldings Journals
Beschreibungen/Notizen
Introduction and Objectives
We aimed to develop a new prediction model of mortality in cancer patients with pneumonia and to compare its performance with CURB‐65 and the Pneumonia Severity Index (PSI).
Methods
Active cancer patients who were diagnosed with pneumonia at the Emergency Department (ED) from 7/1/2014 to 12/31/2014 were consecutively included. Clinical data were collected through a medical chart review. The primary outcome was the 28‐day mortality, and clinical factors were analyzed using logistic regression analysis.
Results
Among a total of 218 analyzed patients with a median age of 64.0 years (IQR, 56.8‐71.0) and a male proportion of 72%, 42 (19.3%) died within 28 days of ED admission. By multivariate logistic regression analysis, an ECOG performance status (PS) 3 (OR: 8.54, 95% CI: 3.42‐21.33) or 4 (OR: 13.17, 95% CI: 3.19‐54.32), SpO2 <90% (OR: 3.06, 95% CI: 1.17‐8.00), and elevated lactic acid levels (OR: 1.42, 95% CI: 1.12‐1.81) were significantly associated with mortality. With these three variables, a new prediction model with total scores ranged from 0 to 6 was generated. The area under the curve of the new prediction model was 0.840, compared with 0.673 and 0.586 for CURB‐65 and PSI, respectively.
Conclusion
In cancer patients with pneumonia, a poor ECOG PS, SpO2 <90%, and lactic acid elevation are independent predictors of mortality. The new prediction model, comprising three predictors, performs better in predicting mortality in cancer patients than CURB‐65 or PSI.