Aliberti et al identified risk factors on admission that are associated with clinical failure in a patient with community-acquired pneumonia (CAP). These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Milan, University of Louisville and Providence Hospital in Washington, DC.
Patient selection: community-acquired pneumonia requiring hospitalization
Parameters present on admission:
(1) age in years
(2) congestive heart failure
(3) blood pressure
(4) gas exchange
(5) pH
(6) body temperature
(7) platelet count
(8) pleural effusion
|
Parameter |
Finding |
Points |
|
age in years |
<= 65 years |
0 |
|
|
> 65 years |
1 |
|
congestive heart failure |
absent |
0 |
|
|
present |
1 |
|
blood pressure |
hypotension |
1 |
|
|
not hypotensive |
0 |
|
gas exchange |
not impaired |
0 |
|
|
impaired |
1 |
|
pH |
< 7.35 (acidosis) |
1 |
|
|
>= 7.35 |
0 |
|
body temperature |
hypothermia |
1 |
|
|
not hypothermia |
0 |
|
platelet count |
>= 100,000 per µL |
0 |
|
|
< 100,000 per µL |
1 |
|
pleural effusion |
absent |
0 |
|
|
present |
1 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 8
• The risk of clinical failure increases with the number of risk factors.
Specialty: Infectious Diseases, Pulmonology
