Huang et al reported a model for predicting in-hospital mortality for a patient with severe community-acquired pneumonia (CAP) and chronic obstructive pulmonary disease (COPD). This can help to identify a patient who may benefit from more aggressive management. The authors are from Sichuan University in Chengdu, China.
Patient selection: adult with CAP and COPD
Parameters:
(1) age in years from 40 to 105
(2) diabetes
(3) chronic kidney disease
(4) systolic blood pressure (SBP) in mm Hg, from 50 to 190
(5) plasma fibrinogen in g/L, from 0 to 10
(6) serum IL6 concentration in pg/mL, from 0 to 260
(7) serum urea in mmol/L, from 0 to 35
points for age =
= (0.8 * (age)) - 32
points for systolic blood pressure =
= 125.129 - (0.659 * (SBP))
points for plasma fibrinogen =
= 8.72 * (fibrinogen)
points for serum IL6 =
= 0.3846 * (IL6)
points for serum urea =
= 1.857 * (urea)
|
Parameter
|
Finding
|
Points
|
|
diabetes
|
no
|
0
|
|
|
yes
|
22
|
|
chronic kidney diseaes
|
no
|
0
|
|
|
yes
|
32.4
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 450.8
value of X =
= (0.03048 * (score)) - 5.246
probability of hospital mortality =
= 1 / (1 + EXP((-1) * X))
Performance:
• The C-index is 0.84 in the training and 0.83 in validation cohorts.
