A prediction rule to identify low-risk patients with community-acquired pneumonia
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Cites background or methods from "A prediction rule to identify low-r..."
...Also, the presence of rare illnesses, such as neuromuscular or sickle cell disease, may require hospitalization but not affect the PSI score....
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...Use of the PSI score in clinical trials has demonstrated some of its limitations, which may be equally applicable to other scoring techniques....
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...Atlas et al. [25] were able to reduce hospital admissions among patients in PSI risk classes I–III from 58% in a retrospective control group to 43% in a PSI-based intervention group....
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...Their guideline used the PSI for admission decision support and included recommendations for antibiotic therapy, timing of first antibiotic dose, measurement of oxygen saturation, and blood cultures for admitted patients....
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...Calculating the PSI score and assigning the risk class, providing oral clarithromycin, and home nursing follow-up significantly ( ) decreased the number of low-P p .01 mortality-risk admissions [25]....
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Cites background from "A prediction rule to identify low-r..."
...Numerous studies have identified risk factors for death in cases of CAP [9, 10, 12]....
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...Independent associations with increased mortality have also been demonstrated for a variety of comorbid illnesses, such as active malignancies [10, 16, 19], immunosuppression [20, 21], neurological disease [19, 22, 23], congestive heart failure [10, 17, 19], coronary artery disease [19], and diabetes mellitus [10, 19, 24]....
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...Mortality is estimated to be !1% for patients not hospitalized [9, 10]....
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...Laboratory and radiographic findings independently associated with increased mortality are hyponatremia [10, 19], hyperglycemia [10, 19], azotemia [10, 19, 27, 28], hypoalbuminemia [16, 19, 22, 25], hypoxemia [10, 19], liver function test abnormalities [19], and pleural effusion [29]....
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...Signs and symptoms independently associated with increased mortality consist of dyspnea [10], chills [25], altered mental status [10, 19, 23, 26], hypothermia or hyperthermia [10, 16, 17, 20], tachypnea [10, 19, 23, 27], and hypotension (diastolic and systolic) [10, 19, 26–28]....
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References
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