Community-Acquired Pneumonia and Pneumonia Severity Index 20 (PSI-20): a study of 262 patients
Keywords:
Community-acquired pneumonia, Pneumonia Severity Index, risk classes, therapeutic, mortalityAbstract
Background: Several prognostic models in patients with Community-aquired Pneumonia (CAP), such as the Pneumonia Severity
Index 20 (PSI-20), have been devised, to assist the physician decide where to treat the patient initially.
Objectives: The main goal of this work was to assess the adequacy of the risk classes defi ned according to the PSI-20 and
hospital admission recommendations, as applied to our population. We also wanted to know the demographic characteristics
and other factors which affect mortality.
Methods: Retrospective study of all the patients admitted with
CAP to our infi rmary over a one-year period. The 20 PSI variables
were collected and the patients stratifi ed into risk classes (I-V).
Results Overall, 262 inpatients with CAP were included; 60%
were males, and 40% females, with a mean age of 72.9 years.
No signifi cant differences were observed in mortality regarding
sex, place of residence or presence of co-morbid conditions, but
there was a signifi cant difference in relation to age.
Treatment was empirical, with advantage for patients treated
with a combination of antibiotics.
The distribution of the patients across the risk classes was:
Class I – 2.3%, Class II – 8.8%, Class III – 16.0%, Class IV
– 45.0% and Class V – 27.9%. The mortality in each class in our
series was similar to the mortality in the PSI study except for Class
II (death of a patient with a severe co-morbid condition).
Conclusions: The PSI-based model performed well when applied
to our population. Most of the low risk-classes (I-III) patients could
have been safely treated as outpatients.
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