Shindo et al evaluated the A-DROP score of the Japanese Respiratory Society (JRS). This can be used to gauge the severity of community-acquired pneumonia (CAP). The authors are from multiple hospitals in Japan.
NOTE: The A-DROP score is based on the CURB-65 score.
Parameters:
(1) A - age and gender
(2) D - dehydration (using BUN)
(3) R – respiratory failure
(4) O – orientation disturbance
(5) P – pressure low
|
Parameter |
Finding |
Points |
|
age and gender |
male and >= 70 years of age |
1 |
|
|
female and >= 75 years of age |
1 |
|
|
neither |
0 |
|
dehydration |
BUN >= 21 mg/dL |
1 |
|
|
BUN < 21 mg/dL |
0 |
|
respiratory failure |
oxygen saturation <= 90% OR PaO2 <= 60 mm Hg |
1 |
|
|
oxygen saturation > 90% AND PaO2 > 60 mm Hg |
0 |
|
orientation disturbance |
present (confused) |
1 |
|
|
absent |
0 |
|
systolic blood pressure |
<= 90 mm Hg |
1 |
|
|
> 90 mm Hg |
0 |
where:
• Presumably the respiratory parameters are on room air.
• BUN is not specific for dehydration.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the more severe the CAP.
Performance:
• The area under the ROC curve was 0.85.
Specialty: Infectious Diseases, Pulmonology
