The performance of SOAR score as a predictor of severity in acute community-acquired pneumonia
Keywords:
Pneumonia/mortality, Severity of Illness Index, Predictive Value of Tests, Community-Acquired InfectionsAbstract
Objective: To evaluate the performance of SOAR score as a predictor of severity in acute community-acquired pneumonia (CAP), and comparatively with the CURB-65 and Severity Index Pneumonia (PSI).
Patients and Methods: Retrospective, observational, cross-sectional study. It included patients older than 14 years diagnosed on admission as CAP during the period of one year. On admission, CURB-65, PSI and SOAR was calculated. The severity of the CAP was assessed by evaluating the requirement of intensive care, need for mechanical ventilatory assistance or hospital death.
Results: 274 patients, 178 (65,0%) males, mean age 49 ± 18.1 years were included. 62 patients presented bacteremia (22.6%). The microorganism most frequently isolated was Streptococcus pneumoniae (n = 30, 48.4%). The SOAR score was effective to assess ICU admission with an OR = 7.7. CI = 3.8 to 15.6 (p <0.001), and ARM requirement with an OR = 9.9. CI = 4.2 to 23.5 (p <0.001). The SOAR effectively predicted mortality score (p <0.001), with an OR: 12.2 CI 3.9 to 38.1, S: 89.5%, E: 76.5%, VPP: 26.3%, VPN: 98.0% although the PSI and CURB-65 were higher, with an OR: 26.6 and 32.4 respectively.
Conclusion: A point of score SOAR classified as severe (≥2 points) indicates increased risk for severe forms of CAP. The SOAR score can be used as an alternative or complementary way together to essential medical judgment.
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