Comparison of severity scoring systems A-DROP and CURB-65 for community-acquired pneumonia

Respirology : Official Journal of the Asian Pacific Society of Respirology
Yuichiro ShindoYoshinori Hasegawa

Abstract

The initial assessment of the severity of community-acquired pneumonia (CAP) is important for patient management. The Japanese Respiratory Society (JRS) has proposed a 6-point scale (0-5) to assess the clinical severity of CAP. The A-DROP scoring system assesses the following parameters: (i) Age (male >or= 70 years, female >or= 75 years); (ii) Dehydration (blood urea nitrogen (BUN) >or= 210 mg/L); (iii) Respiratory failure (SaO(2) <or= 90% or PaO(2) <or= 60 mm Hg); (iv) Orientation disturbance (confusion); and (v) low blood Pressure (systolic blood pressure <or= 90 mm Hg). A-DROP is a modified version of CURB-65 (confusion, BUN > 7 mmol/L (200 mg/L), respiratory rate >or= 30/min, low blood pressure (diastolic <or= 60 mm Hg or systolic < 90 mm Hg, and age >or= 65 years) proposed by the British Thoracic Society. However, validation of A-DROP has not been attempted nor has it been compared with CURB-65. The aim of this study was to confirm that A-DROP is equivalent to CURB-65 for predicting severity of CAP. A retrospective observational study was conducted of patients with CAP hospitalized at a single centre between November 2005 and January 2007. The 30-day mortality after admission was compared following assessment of severity u...Continue Reading

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