Lactate vs CURB 65 and CRB65 as a predictor of clinical outcomes in community-acquired pneumonia
Lactato vs CURB 65 y CRB65 como predictor de resultados clínicos en neumonía adquirida en la comunidad
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Abstract
Introduction: community-acquired pneumonia (CAP) is the leading cause of death from an infectious disease worldwide and in Colombia, hence scales or measures for prognosis prediction are essential for defining its management. Objectives: to evaluate whether lactate and CURB65 and CRB65 severity scores are related to clinical outcomes in hospitalized patients admitted with CAP. Materials and methods: a retrospective study including patients admitted to the emergency room for CAP in two university hospitals in Bogotá. The sensibility, specificity, predictive values, and areas under the curve (AUC) of lactate, CRB65, and CURB65, were established to identify in-hospital mortality, need of intensive care unit (ICU) admission and mechanical ventilation (MV). Results: 153 patients were included, 78 (51%) were men and the median age was 75 years (IQR 62 - 83). The AUC to identify in-hospital mortality was 0.76 (CI 95%=0.65-0.87) for CURB65, and 0.70 (CI 95%=0.56-0.83) for lactate. Regarding patients requiring ICU admission, CURB65 had an AUC=0.77 (IC 95%=0.69-0.86) and lactate an AUC=0.67 (IC 95%= 0.54-0.80). Combining lactate and CURB65 did not improve the AUCs for the evaluated outcomes. Conclusion: in the study population, CURB-65 better predicted clinical outcomes in patients hospitalized for CAP. Adding lactate did not improve prognosis assessment.
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