Predictors of Mortality for Nursing Home-Acquired Pneumonia: A Systematic Review
Background. Current risk stratification tools, primarily used for CAP, are suboptimal in predicting nursing home acquired pneumonia (NHAP) outcome and mortality. We conducted a systematic review to evaluate current evidence on the usefulness of proposed predictors of NHAP mortality. Methods. PubMed...
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doaj-1da7490a5634464c9a954a4d30f7fe712020-11-24T21:58:16ZengHindawi LimitedBioMed Research International2314-61332314-61412015-01-01201510.1155/2015/285983285983Predictors of Mortality for Nursing Home-Acquired Pneumonia: A Systematic ReviewNaveen Dhawan0Naushira Pandya1Michael Khalili2Manuel Bautista3Anurag Duggal4Jaya Bahl5Vineet Gupta6Nova Southeastern University Health Sciences Division, Fort Lauderdale, FL 33314, USANova Southeastern University Health Sciences Division, Fort Lauderdale, FL 33314, USAThe Commonwealth Medical College, Scranton, PA 18509, USADivision of Pulmonary Medicine, Northeast Ohio Medical University College of Medicine, Rootstown, OH 44272, USADivision of Infectious Diseases, Medina Hospital (Cleveland Clinic), Medina, OH 44256, USAFlorida International University (FIU), North Miami Beach, FL 33181, USADepartment of Medicine, University of California San Diego (UCSD), 200 West Arbor Drive, San Diego, CA 92103, USABackground. Current risk stratification tools, primarily used for CAP, are suboptimal in predicting nursing home acquired pneumonia (NHAP) outcome and mortality. We conducted a systematic review to evaluate current evidence on the usefulness of proposed predictors of NHAP mortality. Methods. PubMed (MEDLINE), EMBASE, and CINAHL databases were searched for articles published in English between January 1978 and January 2014. The literature search elicited a total 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 need of ICU care) as useful predictors for NHAP mortality. There is weak evidence for biomarkers like C-reactive protein and copeptin as prognostic tools. Conclusion. The evidence supports the use of PSI as the best available indicator while CURB-65 may be an alternative prognostic indicator for NHAP mortality. Overall, due to the paucity of information, biomarkers may not be as effective in this role. Larger prospective studies are needed to establish the most effective predictor(s) or combination scheme to help clinicians in decision-making related to NHAP mortality.http://dx.doi.org/10.1155/2015/285983 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Naveen Dhawan Naushira Pandya Michael Khalili Manuel Bautista Anurag Duggal Jaya Bahl Vineet Gupta |
spellingShingle |
Naveen Dhawan Naushira Pandya Michael Khalili Manuel Bautista Anurag Duggal Jaya Bahl Vineet Gupta Predictors of Mortality for Nursing Home-Acquired Pneumonia: A Systematic Review BioMed Research International |
author_facet |
Naveen Dhawan Naushira Pandya Michael Khalili Manuel Bautista Anurag Duggal Jaya Bahl Vineet Gupta |
author_sort |
Naveen Dhawan |
title |
Predictors of Mortality for Nursing Home-Acquired Pneumonia: A Systematic Review |
title_short |
Predictors of Mortality for Nursing Home-Acquired Pneumonia: A Systematic Review |
title_full |
Predictors of Mortality for Nursing Home-Acquired Pneumonia: A Systematic Review |
title_fullStr |
Predictors of Mortality for Nursing Home-Acquired Pneumonia: A Systematic Review |
title_full_unstemmed |
Predictors of Mortality for Nursing Home-Acquired Pneumonia: A Systematic Review |
title_sort |
predictors of mortality for nursing home-acquired pneumonia: a systematic review |
publisher |
Hindawi Limited |
series |
BioMed Research International |
issn |
2314-6133 2314-6141 |
publishDate |
2015-01-01 |
description |
Background. Current risk stratification tools, primarily used for CAP, are suboptimal in predicting nursing home acquired pneumonia (NHAP) outcome and mortality. We conducted a systematic review to evaluate current evidence on the usefulness of proposed predictors of NHAP mortality. Methods. PubMed (MEDLINE), EMBASE, and CINAHL databases were searched for articles published in English between January 1978 and January 2014. The literature search elicited a total 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 need of ICU care) as useful predictors for NHAP mortality. There is weak evidence for biomarkers like C-reactive protein and copeptin as prognostic tools. Conclusion. The evidence supports the use of PSI as the best available indicator while CURB-65 may be an alternative prognostic indicator for NHAP mortality. Overall, due to the paucity of information, biomarkers may not be as effective in this role. Larger prospective studies are needed to establish the most effective predictor(s) or combination scheme to help clinicians in decision-making related to NHAP mortality. |
url |
http://dx.doi.org/10.1155/2015/285983 |
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