Rendimiento de la escala Severe Community Acquired Pneumonia (SCAP) para la predicción de desenlaces clínicos en neumonía

Abstract

Objective: to assess the performance of the SCAP score for the prediction of in-hospital mortality, 30-day mortality, requirement of invasive mechanical ventilation (IMV) and of vasopressor support, in patients with community-acquired pneumonia (CAP). Methods: retrospective cohort study with diagnostic test analysis of the SCAP and CURB-65 scores in patients with CAP according to the ATS/IDSA criteria. An additional SCAP score in which PaO2/FiO2<250 was replaced for SpO2/FiO2<400 was estimated. The crude and adjusted OR per each variable of score and outcomes of interest were calculated, as well as the areas under the receiver operating characteristic curve (AUROCs). AUROCs were compared with the DeLong test and a p<0,05 was considered statistically significant. Results: 1795 patients were included in the final analysis, 13,6% of them died in-hospital, 15% within 30 days of hospital admission, 10,8% required IMV and 11,4% required vasopressor support. The SCAP score’s sensitivity for the prediction of the four outcomes previously mentioned was higher than that of the CURB-65 score. The performance did not modify when SpO2/FiO2<400 is used as criteria. Conclusions: the SCAP score shows good performance for predicting clinical outcomes in pneumonia, maintaining its performance when SpO2/FiO2<400 is used.

Keywords

• pneumonia; clinical outcome; mortality; intensive care unit; mechanical ventilation; vasoconstrictors; hypoxia.