Viral prevalence, clinical profiles and comparison of severity scores for predicting the mortality of adults with severe acute respiratory infections
Viral prevalence, clinical profiles and comparison of severity scores for predicting the mortality of adults with severe acute respiratory infections
Background/aim: The aim of this study was to determine the accuracy of severity scores for predicting the 28-day mortality amongadults with severe acute respiratory infection (SARI) admitted to the emergency department.Materials and methods: This study included 159 consecutive adult patients with SARI admitted to the emergency department of atertiary hospital. A standard form was filled out in order to record demographic information, clinical parameters, laboratory tests, andradiographic findings of the patients. CURB-65, PSI, SIRS, qSOFA, SOFA and APACHE II scores were compared between the survivorand nonsurvivor groups.Results: Of 159 patients included in the study, 38.4% were positive for respiratory viruses and 28.3% were positive for influenza viruses.35.8% of the patients were admitted to an intensive care unit (ICU) and the mortality rate was 36.5%. The area under the receiveroperating characteristic curve of CURB-65, PSI, SIRS criteria, qSOFA, SOFA and APACHE II scores were 0.717, 0.712, 0.607, 0.683,0.755, and 0.748, respectively in predicting mortality and 0.759, 0.744, 0.583, 0.728, 0.741, and 0.731, respectively in predicting ICUadmission.Conclusion: SOFA and APACHE II were more accurate than SIRS in predicting the 28-day mortality among adults with SARI. Therewas no significant difference among these scores in terms of other multivariate comparisons.
___
- 1. Willams BG, Gouws E, Boschi-Pinto C, Bryce J, Dye C.
Estimates of World-wide distribibution of child deaths from
acute respiratory infections. The Lancet Infectious Diseases
2002; 2 (1): 25-32. doi.org/10.1016/S1473-3099(01)00170-0
- 2. World Health Organization. Global Epidemiological Surveillance
Standards for Influenza. Geneva, Switzerland: WHO Library
Cataloguing; 2014.
- 3. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell
GD et al. Infectious Diseases Society of America/American
Thoracic Society consensus guidelines on the management of
community-acquired pneumonia in adults. Clinical Infectious
Diseases 2007; 44: 27-72. https://doi.org/10.1086/511159
- 4. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM et al.
Definitions for sepsis and organ failure and guidelines for the
use of innovative therapies in sepsis. Chest 1992; 101: 1644. doi.
org/10.1378/chest.101.6.1644
- 5. Singer M, Deutschman CS, Seymour CW, ShankarHari M, Annane D et al. The third international consensus
definitions for sepsis and septic shock. JAMA 2016; 315: 801-810.
doi: 10.1001 / JAMA.2016.0287
- 6. Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD
et al. Assessment of clinical criteria for sepsis: for the Third
International Consensus Definitions for Sepsis and Septic
Shock (Sepsis-3). JAMA 2016; 315: 762-774. doi: 10.1001 /
JAMA.2016.0288
- 7. Sakr Y, Ferrer R, Reinhart K, Beale R, Rhodes A et al. The
intensive care global study on severe acute respiratory infection
(IC-GLOSSARI): a multicenter, multinational, 14-day inception
cohort study. Intensive Care Medicine 2016; 42 (5): 817-828.
doi : 10.1007 / s00134-015-4206-2
- 8. Zhang C, Zhu N, Xie Z, Lu R, He B et al. Viral etiology and
clinical profiles of children with severe acute respiratory
infections in China. PloS One 2013; 8: e72606. doi.org/10.1371/
journal.pone.0072606
- 9. Singleton RJ, Bulkow LR, Miernyk K, DeByle C, Pruitt L et al.
Viral respiratory infections in hospitalized and community
control children in Alaska. Journal of Medical Virology 2010; 82
(7): 1282-1290. doi.org/10.1002/jmv.21790
- 10. Al-Abdallat M, Dawson P, Haddadin AJ, El-Shoubary W,
Dueger E et al. Influenza hospitalization epidemiology from a
severe acute respiratory infection surveillance system in Jordan,
January 2008-February 2014. Influenza and Other Respiratory
Viruses 2016; 10 (2): 91-97. doi.org/10.1111/irv.12354
- 11. Feikin DR, Njenga MK, Bigogo G, Aura B, Aol G et al. Viral and
bacterial causes of severe acute respiratory illness among children
aged less than 5 years in a high malaria prevalence area of western
Kenya, 2007-2010. The Pediatric Infectious Disease Journal 2013;
32 (1): e14-e9. doi: 10.1097 / INF.0b013e31826fd39b
- 12. Suryaprasad A, Redd JT, Hancock K, Branch A, Steward-Clark
E et al. Severe acute respiratory infections caused by 2009
pandemic influenza A (H1N1) among American Indians—
southwestern United States, May 1-July 21, 2009. Influenza
and Other Respiratory Viruses 2013; 7 (6):1361-1369. doi.
org/10.1111/irv.12123
- 13. Wansaula Z, Olsen SJ, Casal MG, Golenko C, Erhart LM et al.
Surveillance for severe acute respiratory infections in Southern
Arizona, 2010-2014. Influenza and Other Respiratory Viruses
2016; 10 (3): 161-169. doi.org/10.1111/irv.12360
- 14. Jones AH, Ampofo W, Akuffo R, Doman B, Duplessis C et
al. Sentinel surveillance for influenza among severe acute
respiratory infection and acute febrile illness inpatients at three
hospitals in Ghana. Influenza and Other Respiratory Viruses
2016; 10 (5): 367-74. doi.org/10.1111/irv.12397
- 15. Meerhoff TJ, Simaku A, Ulqinaku D, Torosyan L, Gribkova N
et al. Surveillance for severe acute respiratory infections (SARI)
in hospitals in the WHO European region-an exploratory
analysis of risk factors for a severe outcome in influenzapositive SARI cases. BMC Infectious Diseases 2015; 15 (1): 1.
doi.org/10.1186/s12879-014-0722-x
- 16. Hanshaoworakul W, Simmerman JM, Narueponjirakul U,
Sanasuttipun W, Kaewchana S, et al. Severe human influenza
infections in Thailand: oseltamivir treatment and risk factors
for fatal outcome. Plos One 2009; 4 (6): e6051. doi.org/10.1371/
journal.pone.0006051
- 17. Kumar A. Early versus late oseltamivir treatment in severely
ill patients with 2009 pandemic influenza A (H1N1): speed is
life. Journal of Antimicrobial Chemotherapy 2011; 66 (5): 959-
963. doi.org/10.1093/jac/dkr090
- 18. Fine WS, van der Eerden MM, Laing R, Boersma WG, Karalus
N et al. Defining community acquired pneumonia severity
on presentation to hospital: an international derivation and
validation study. Thorax 2003; 58 (5): 377-382. doi.org/10.1136/
thorax.58.5.377
- 19. Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA et al. A
prediction rule to identify low-risk patients with communityacquired pneumonia. New England Journal of Medicine 1997;
336 (4): 243-250. doi: 10.1056/NEJM199701233360402
- 20. Capelastegui A, Espana P, Quintana J, Areitio I, Gorordo I et al.
Validation of a predictive rule for the management of communityacquired pneumonia. European Respiratory Journal 2006; 27
(1): 151-157. doi:10.1183 / 09031936.06.00062505
- 21. Aujesky D, Auble TE, Yealy DM, Stone RA, Obrosky DS et al.
Prospective comparison of three validated prediction rules for
prognosis in community-acquired pneumonia. The American
Journal of Medicine 2005; 118 (4): 384-392. doi.org/10.1016/j.
amjmed.2005.01.006
- 22. Challen K, Bright J, Bentley A, Walter D. Physiological-social
score (PMEWS) vs. CURB-65 to triage pandemic influenza:
a comparative validation study using community-acquired
pneumonia as a proxy. BMC Health Services Research 2007: 7
(1); 33. doi.org/10.1186/1472-6963-7-33
- 23. Loke YK, Kwok CS, Niruban A, Myint PK. Value of severity
scales in predicting mortality from community-acquired
pneumonia: systematic review and meta-analysis. Thorax
2010; 65 (10): 884-890. doi.org/10.1136/thx.2009.134072
- 24. Chalmers JD, Mandal P, Singanayagam A, Akram AR,
Choudhury G et al. Severity assessment tools to guide ICU
admission in community-acquired pneumonia: systematic
review and meta-analysis. Intensive Care Medicine 2011; 37:
1409-1420. doi : 10.1007 / s00134-011-2261-x
- 25. Freund Y, Lemachatti N, Krastinova E, Van Laer M, Claessens
Y-E et al. Prognostic accuracy of sepsis-3 criteria for in-hospital
mortality among patients with suspected infection presenting
to the emergency department. JAMA 2017; 317 (3): 301-308.
doi: 10,1001 / JAMA.2016.20329
- 26. Raith EP, Udy AA, Bailey M, McGloughlin S, MacIsaac C et
al. Prognostic accuracy of the SOFA score, SIRS criteria, and
qSOFA score for in-hospital mortality among adults with
suspected infection admitted to the intensive care unit. JAMA
2017; 317 (3): 290-300. doi: 10,1001 / JAMA.2016.20328
- 27. Tokioka F, Okamoto H, Washio Y, Yamazaki A, Ito A et al.
Predictive performance of quick sepsis-related organ failure
assessment for mortality and intensive care unit admission
among patients with community-acquired pneumonia.
In: Proceedings of the American Thoracic Society 2017
International Conference; Washington, DC, USA. pp. A3952
- 28. Desai S, Lakhani JD. Utility of SOFA and APACHE II score
in sepsis in rural set up MICU. Journal of Association of
Physicians of India 2013; 61: 608-611.
- 29. Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J et al.
Critically ill patients with 2009 influenza A (H1N1) infection
in Canada. JAMA 2009; 302 (17): 1872-1879. doi: 10.1001 /
JAMA.2009.1496
- 30. Serafim R, Gomes JA, Salluh J, Póvoa P. A comparison of the
quick-sofa and systemic inflammatory response syndrome
criteria for the diagnosis of sepsis and prediction of mortality:
a systematic review and meta-Analysis. Chest 2018; 153 (3):
646-655. doi.org/10.1016/j.chest.2017.12.015