Aliberti et al developed a score for identifying a patient with community-acquired pneumonia (CAP) who is at risk for having a multi-drug resistant pathogen. The authors are from the University of Milan and Ospedale Maggiore Policlinico in Italy.
Parameters:
(1) comorbidities
(2) housing
(3) recent hospitalization
(4) chronic renal failure
Comorbidities:
(1) cerebrovascular disease
(2) diabetes
(3) COPD
(4) immunosuppression
(5) antimicrobial therapy in the past 90 days (3 months)
(6) home wound care
(7) home infusion therapy
Parameter
Finding
Points
comorbidities
0
0
>= 1
0.5
housing
extended care facility or nursing home
3
other
0
recent hospitalization
>= 2 days in past 90 days
4
0 or 1
0
chronic renal failure
absent
0
present
5
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12.5
• The higher the score the greater the risk of a multi-drug-resistant pathogen.
Total Score
Risk
0 or 0.5
low (8%)
>= 3
high (38%)
Performance:
• The area under the ROC curve is 0.79.
• For a score > 0.5 the sensitivity is 75% and specificity 71%.
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