استفاده از روش 60-CURB و 60-CRB در تعیین پیش‌آگهی پنومونی اکتسابی از جامعه‌ی سالمندان

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استادیار، گروه بیماری‌های عفونی و گرمسیری و مرکز تحقیقات سل و بیماری‌های عفونی اطفال، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اراک، اراک، ایران

2 دانشیار، گروه بیماری‌های عفونی و گرمسیری و مرکز تحقیقات سل و بیماری‌های عفونی اطفال، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اراک، اراک، ایران

3 دانشجوی پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اراک، اراک، ایران

چکیده

مقدمه: با توجه به افزایش میزان مرگ و میر ناشی از پنومونی در افراد سالمند، استفاده از مدل ساده‌تر برای تعیین پیش‌آگهی پنومونی می‌تواند به کاهش میزان مرگ و میر در این گروه سنی بیانجامد. هدف این مطالعه، تعیین اعتبار مدل 60-CURB (years 60 ≤ Confusion, uremia, respiratory rate, blood pressure, and age) و مدل 60-CRB (years 60 ≤ Confusion, respiratory rate, blood pressure, and age) و مقایسه‌ی آن با مدل‌های PSI (Pneumonia severity index) و 65-CURB و 65-CRB بود.روش‌ها: این مطالعه یک مطالعه‌ی توصیفی- مقطعی بود که در سال 1392 در دانشگاه علوم پزشکی اراک به انجام رسید. اطلاعات 141 بیمار 60 سال و بالاتر مبتلا به پنومونی اکتسابی از جامعه که دارای شرایط ورود به مطالعه بودند، به وسیله‌ی نرم‌افزار SPSS نسخه‌ی 18  مورد تجزیه و تحلیل قرار گرفت. 050/0 ≥ P معنی‌دار تلقی شد.یافته‌ها: میانگین سنی بیماران در این مطالعه، 6/7 ± 9/68 و میانه 65 سال بود. 76 بیمار (9/53 درصد) مذکر و نسبت جنسی مرد به زن 17/1 بود. 6/71 درصد بیماران ساکن شهر بودند. شایع‌ترین بیماری‌های همراه بیماری‌های قلبی- عروقی (6/37 درصد) بود. شایع‌ترین علامت رال و رونکای (2/92 درصد) و هپپوترمی یا هیپرترمی (7/88 درصد) بود. از نظر بهبودی روز سوم حساسیت، ویژگی و ارزش اخباری مثبت مدل PSI (Pneumonia severity index) و 60-CURB بیشتر از سایر مدل‌ها بود و از نظر بستری در ICU (Intensive care unit) تا روز چهاردهم و مرگ تا روز سی‌ام بیشترین ارزش اخباری مثبت مربوط به مدل 65-CURB و 60-CRB بود.نتیجه‌گیری: برای تعیین شدت و پیش‌آگهی پنومونی اکتسابی از جامعه در سالمندان، می‌توان از مدل 60-CURB و مدل 60-CRB استفاده نمود.

کلیدواژه‌ها

عنوان مقاله [English]

Validity of Confusion, Uremia, Respiratory Rate, Blood Pressure, and Age ≥ 60 Years (CURB-60) and Confusion, Respiratory Rate, Blood Pressure, and Age ≥ 60 (CRB-60) in Determining the Prognosis of Community-Acquired Pneumonia in the Elderly

نویسندگان [English]

  • Aliasghar Farazi 1
  • Masoomeh Sofian 2
  • Banafsheh Nayebzadeh 3
1 Assistant Professor, Department of Infectious Disease and Tuberculosis AND Pediatric Infectious Research Center, School of Medicine, Arak University of Medical Sciences, Arak, Iran
2 Associate Professor, Department of Infectious Disease and Tuberculosis AND Pediatric Infectious Research Center, School of Medicine, Arak University of Medical Sciences, Arak, Iran
3 Student of Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran
چکیده [English]

Background: Due to high rates of mortality from pneumonia in the elderly, using a simple model for determining the prognosis of pneumonia can lead to a decrease in the mortality rate in this group. This study aimed to determine the validity of confusion, uremia, respiratory rate, blood pressure, and age ≥ 60 years (CURB-60) and confusion, respiratory rate, blood pressure, and age ≥ 60 (CRB-60) models in determining the prognosis of community-acquired pneumonia in the elderly and comparison them with models of the pneumonia severity index (PSI), CURB-65, and CRB-65.Methods: This cross-sectional study was conducted in 2013 in Arak University of Medical Sciences, Iran. Data of 141 patients with the age of 60 years and older with community-acquired pneumonia who had inclusion criteria were included in the study and analyzed. P-value < 0.05 was considered significant.Findings: The mean age of patients was 68.9 ± 7.6 with the median of 65.0 years. 76 patients (53.9%) were men and sex ratio of men/women was 1.17. 71.6% of patients were in urban areas. The most common comorbidity was cardiovascular disease (37.6%) and the most common sign and symptom were respiratory rale (92.2%), hypothermia or hyperthermia (88.7%), respectively. Sensitivity, specificity and positive predictive value of PSI and CURB-60 model for third day recovery were higher than the other models. The highest positive predictive value of intensive care unit (ICU) admission until the fourteenth day and 30-day mortality were in the models of CURB-65 and CRB-60.Conclusion: To determine the severity and prognosis of community-acquired pneumonia in the elderly, CURB-60 and CRB-60 models can be used.

کلیدواژه‌ها [English]

  • Community-acquired pneumonia
  • Confusion
  • uremia
  • respiratory rate
  • Blood Pressure
  • and age ≥ 60 years (CURB-60)
  • and age ≥ 60 (CRB-60)
  • Elderly

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مجله دانشکده پزشکی اصفهان
دوره 32، شماره 275 - شماره پیاپی 275
فروردین و اردیبهشت 1393
صفحه 149-159

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سابقه مقاله

  • تاریخ دریافت: 06 دی 1392
  • تاریخ بازنگری: 12 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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