Chalmers et al developed a simple risk score for identifying a patient with community-acquired pneumonia who is at risk for a parapneumonic effusion or empyema. The authors are from the Royal Infirmary in Edinburgh.
Parameters:
(1) serum albumin
(2) serum C-reactive protein (CRP)
(3) platelet count
(4) serum sodium
(5) history of intravenous drug use
(6) history of chronic alcohol abuse
(7) history of chronic obstructive pulmonary disease (COPD)
|
Parameter |
Finding |
Points |
|
serum albumin |
>= 30 g/L |
0 |
|
|
< 30 g/L |
1 |
|
serum C-reactive protein |
<= 100 mg/L |
0 |
|
|
> 100 mg/L |
1 |
|
platelet count |
<= 400 * 10^9/L |
0 |
|
|
> 400 * 10^9/L |
1 |
|
serum sodium |
>= 130 mmol/L |
0 |
|
|
< 130 mmol/L |
1 |
|
history of IV drug use |
no |
0 |
|
|
yes |
1 |
|
history of chronic alcohol abuse |
no |
0 |
|
|
yes |
1 |
|
history of COPD |
no |
0 |
|
|
yes |
-1 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: -1
• maximum score: 6
• The higher the score the greater the risk of a complicated course.
• A score >= 2 was used to identify the high risk group.
Performance:
• The cutoff >= 2 had a sensitivity of 87% and specificity of 68%.
• The positive predictive value was low (18%) but the negative predictive value was almost 99%.
Specialty: Infectious Diseases, Pulmonology
ICD-10: ,
