Abstrait
Diagnostic Significance of Quality Markers and Death Predictors for Older Patients with Home Health Pneumonia: A Meta Analysis
Rachael MartinBackground
Current risk stratification tools, primarily used for CAP, are suboptimal in predicting home acquired pneumonia (NHAP) outcome and mortality. We conducted a scientific review to evaluate current evidence on the usefulness of proposed predictors of NHAP mortality.
Methods
PubMed (MEDLINE), EMBASE, and CINAHL databases were looked for articles published in English between January 1978 and January 2014. The literature search elicited a complete of 666 references; 580 were excluded and 20 articles met the inclusion criteria for the final analysis.
Results
More studies supported the Pneumonia Severity Index (PSI) as a superior predictor of NHAP severity. Fewer studies suggested CURB-65 and SOAR (especially for the necessity of ICU care) as useful predictors for NHAP mortality. there's weak evidence for biomarkers like C-reactive protein and copeptin as prognostic tools.
Conclusion
The evidence supports the utilization of PSI as the best available indicator while CURB-65 may be an alternative prognostic indicator for NHAP mortality. Overall, thanks to the paucity of information, biomarkers might not be as effective in this role. Larger prospective studies are needed to determine the most effective predictor(s) or combination scheme to help clinicians in decision-making related to NHAP mortality