Ma et al reported a clinical risk score for identifying an older Chinese adult who may have antibiotic-resistant bacterial pneumonia. This can help to identify a patient who may require more aggressive management. The authors are from Prince of Wales Hospital and The Chinese University of Hong Kong.
Patient selection: Chinese adult >= 65 years of age, excluding hospitalization within the past 14 days or transfer from another hospital with a diagnosis of suspected nosocomial pneumonia
Parameters:
(1) bronchiectasis
(2) recent hospitalization
(3) severe pneumonia
(4) other factors (nursing home residence, home infusion therapy, chronic wound care, chronic dialysis, immunosuppression)
Parameter
Finding
Points
bronchiectasis
absent
0
present
14
recent hospitalization
no
0
yes
5
severe pneumonia
no
0
yes
2
other risk factor
none
0
1 or more
0.5
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 21.5
• A score >= 2.5 was used to identify a patient at risk for antibiotic-resistant pneumonia.
• A score >= 7.5 indicates high risk for antibiotic-resistant pneumonia.
Performance:
• The area under the ROC curve was 0.75 for the derivation and 0.67 for the validation cohorts.
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