The pneumonia severity index and the CRB-65 in cancer patients with community-acquired pneumonia

S. Aliberti, G. N. Brock, P. Peyrani, F. Blasi, Julio A. Ramirez

Research output: Contribution to journalArticle

Abstract

SETTING: The ability of the pneumonia severity index (PSI) and the CRB-65 to identify patients with low vs. high risk for mortality among cancer patients with CAP has not been evaluated. DESIGN: Subjects with cancer, CAP/Ca(+), and without cancer, CAP/Ca(-), were identified from the Community-Acquired Pneumonia Organization database. Mortality for both groups was analyzed by comparing low vs. high risk for mortality for the PSI (Risk Class I, II and III vs. IV and V) and the CRB-65 score (scores 0 and 1 vs. 2, 3 and 4). RESULTS: A total of 2621 patients were included in the CAP/Ca(-) group and 280 in the CAP/Ca(+) group. In the CAP/Ca(+) group, no significant difference in mortality was detected in low vs. high risk populations, either for the PSI (P = 0.288) or for the CRB-65 score (P = 0.281). Analyzing the receiver operator characteristic curves, the concordance indexes for the CAP/Ca(+) group were respectively 0.53 and 0.54 for PSI and CRB-65. By fitting a multivariable logistic regression model, a significantly different trend in mortality was found between the CAP/Ca(-) and CAP/Ca(+) groups for both scoring systems. CONCLUSION: Clinical judgment will continue to be the physicians' primary tool in defining the site of care for cancer patients with CAP.

Original languageEnglish
Pages (from-to)1550-1556
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume13
Issue number12
Publication statusPublished - Dec 2009

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Keywords

  • Cancer, pneumonia severity index
  • Clinical research
  • Community-acquired pneumonia
  • CRB-65

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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