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Risk Score for Identifying MRSA Pneumonia

Purpose: To evaluate a patient who is presenting to a hospital with pneumonia due to MRSA using the risk score of Shorr et al.

Description

Shorr et al reported a score for identifying a patient who is presenting to a hospital with pneumonia due to methicillin-resistant Staphyloccous aureus (MRSA). This can help to identify a patient who may require more specific antibiotic therapy. The authors are from Washington Hospital Center in the District of Columbia.


Patient selection: presenting to the hospital with pneumonia

 

Parameters:

(1) age in years

(2) recent hospitalization for >= 2 days within the last 90 days

(3) exposure to nursing home, skilled nursing facility or long-term acute care in the last 90 days

(4) history of intravenous antibiotics within the past 30 days

(5) admission to the ICU during this hospital stay

(6) history of any cerebrovascular disease

(7) dementia

(8) sex and diabetes mellitus

 

Parameter

Finding

Points

age

< 30 years

1

 

30 to 79 years

0

 

> 79 years

1

recent hospital stay

no

0

 

yes

2

exposure to nursing home

no

0

 

yes

1

prior IV antibiotics

no

0

 

yes

1

admitted to ICU

no

0

 

yes

2

history of cerebrovascular disease

no

0

 

yes

1

dementia

no

0

 

yes

1

diabetes mellitus

yes and male

0

 

yes and female

1

 

no

0

 

total score =

= SUM(points for all 8 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 10

 

Total Score

Risk of MRSA

0 or 1

low (10%)

2 to 5

medium (20%)

6 to 10

high (> 30%)

 

Performance:

• The area under the ROC curve for the development set was 0.66.


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Specialty

Objective

ICD-10