Validation of a Prediction Rule for Prognosis of Severe Community- Acquired Pneumonia



Olivier Leroy*, Dorota Mikolajczyk, Patrick Devos, Arnaud Chiche, Nicolas Van Grunderbeeck, Nicolas Boussekey, Serge Alfandari, Hugues Georges
Service de Réanimation et Maladies Infectieuses. Hôpital Chatiliez. Tourcoing 59, France; Département de Bio Statistiques. CHRU Lille 59, France.


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© Leroy et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Service de Réanimation et Maladies infectieuses, Hôpital Chatiliez, 135 rue du Président Coty, 59200 Tourcoing, France; Tel: 33 3 20 69 44 30; Fax: 33 3 20 69 44 39; E-mail: oleroy@ch-tourcoing.fr


Abstract

In a previous study, we developed a prognostic prediction rule, based on nine prognostic variables, capable to estimate and to adjust the mortality rate of patients admitted in intensive care unit for severe community-acquired pneumonia. A prospective multicenter study was undertaken to evaluate the performance of this rule. Five hundred eleven patients, over a 7-year period, were studied. The ICU mortality rate was 29.0%. In the 3 initial risk classes, we observed significantly increasing mortality rates (8.2% in class I, 22.8% in class II and 65.0% in class III) (p<0.001). Within each initial risk class, the adjustment risk score identified subclasses exhibiting significantly different mortality rates: 3.9% and 33.3% in class I; 3.1%, 12.9% and 63.3% in class II; and 55.8% and 82.5% in class III. Compared with mortality rates predicted by our previous study, only a few significant differences were observed. Our results demonstrate the performance and reproductibility of this prognostic prediction rule.

Keywords: Intensive care, community-acquired pneumonia, prognostic score..