Clinical & Medical CASE REPORTS

Biography

Xin Wang has completed his PhD &MD from Tianjin Medical University. He is the Head of the department of internal medicine, a premier research organization. He has published more than 5 papers in reputed journals and has been serving as an editorial board member of reputed journals.

Abstract

The aim of this study is to develop a new method that is able to accurately predict the 28 day hospital mortality in patients with severe community acquired pneumonia (SCAP) at an early stage. Methods: Weselected 37,348 SCAP patients in ICU from173 hospitals during 2011.1–2013.12. The predictive factors for 28 day hospital mortality were evaluated retrospectively. All cases underwent intensive care, blood routine, blood biochemical tests and arterial blood gas analysis. Under the Classification and Regression Tree (CART) analysis, a new clinical scoring system was developed for early prediction in SCAP patients. The receiver-operating characteristic (ROC) curve was plotted to calculate the area under the receiver operating characteristic curve (AUC). Results: A novel clinical model named CLCGHscoring system, including Serum creatinine (Cr) ≥259.5 μmol/L, leukocyte (WBC)≥ 17.35 × 109 /L, C-reactive protein (CRP) ≥189.4 μg/mL, GCS ≤ 9 and serumHCO3− ≤ 17.65mmol/L, was carried out and each index as an independent factor for hospital mortality in SCAP. In the validation cohort, the AUC of the new scoring system was 0.889 for prediction of hospital mortality, which was similar to SOFA score 0.877, APACHEII score 0.864, and was better than the PSI score 0.761 and CURB-65 score 0.767. Conclusions: The new scoring systemCLCGH is an efficient, accurate and objective method to predicate the early hospital mortality among SCAP patients.