Abstract
Aims:To assess the accuracy of a new physiological score, SIPF (shock index and hypoxemia) score, as a predictor of ICU admission and mortality in community-acquired pneumonia (CAP)
Methods:We designed a qualitative SIPF score as the combination of shock index (heart rate/systolic blood pressure) ›0.7 (1 point) plus PaO2/FiO2‹250 (1 point), scoring 0-2 points. We analyzed the accuracy of SIPF score compared to PSI, CURB-65 and ATS/IDSA minor criteria (mc) to predict ICU admission and mortality. We used X2 test and ROC curves to severity scores and outcomes.
Results: We analyzed 1090 CAP patients: 54% showed PSI IV-V, 42.4% were CURB-65 2-5, 13.7% scored 3 or more ATS/IDSAmc, and 16.9% rated 2 points in SIPF score. Complications were developed in 90 cases (8.3%), and 75 patients (6.9%) required ICU admission. Mortality was 5.4%. Mortality according to SIPF score was: 0 points (11.9%), 1 point (40.7%), and 2 points (47.5%). ICU admission was associated with ATS/IDSAmc (OR 4.04; 95%CI 1.91-8.54), and SIPF score (OR 2.33; 95%CI 1.29-4.20). The ability to predict ICU admission was higher for SIPF scored compared to PSI (p<0.01) and CURB-65 (p<0.01) and similar to ATS/IDSAmc (p=0.636). Factors associated with mortality were: PSI IV-V (OR 7.75; 95%CI 2.23-29.96), ATS/IDSAmc (OR 2.54; 95%CI 1.38-4.70), and SIPF score (OR 2.40; 95%CI 1.03-5.58).
Conclusions:
1-The ability of SIPF score to predict ICU admission in CAP is similar to that of ATS/IDSAmc and higher that of PSI and CURB-65.
2-SIPF score is as accurate as ATS/IDSAmc, PSI and CURB to predict mortality in CAP.
3- The simple SIPF score could be a useful tool to predict ICU admission and mortality in CAP.
- © 2014 ERS