Validation of a Risk-Based Biomarker-Enhanced Scoring System for Lower Respiratory Tract Infections (OPTIMA I Basel)—An Observational Survey

Silva, Richard X. Sousa Da and Dusemund, Frank and Nickel, Christian and Bingisser, Roland and Huber, Andreas and Müller, Beat and Albrich, Werner C. (2013) Validation of a Risk-Based Biomarker-Enhanced Scoring System for Lower Respiratory Tract Infections (OPTIMA I Basel)—An Observational Survey. International Journal of Clinical Medicine, 04 (02). pp. 69-77. ISSN 2158-284X

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Abstract

Background: Despiteits recommendation in management guide lines for community acquired pneumonia (CAP), the CURB65 score is frequently not followed for disposition decisions in clinical routine. We therefore proposed an improved CURB65 A score, supplemented by proadre nome dull in (ProADM) levels for patients with CAP and other lower respiratory tract infections (LRTIs). In this study, we vali dated this risk based biomarker enhanced disposition in patients with LRTIs presenting to the emergency department of the University Hospital of Basel. Methods: In this prospective observational cohort study of 85 patients presenting with LRTIs, site of care was decided by the physicians in charge according to their judgement. Retro spectively the CURB65 A score was calculated and a virtual disposition assigned. This was compared with the existing disposition in order to identify efficacy of the novel risk based biomarker enhanced disposition. Results: The novel disposition criteria considered 14 patients suitable for outpatient treatment compared to 11 in the current disposition (p = 0.5). It detected 7 patients to be best treated outside the hospital for nursing reasons, while the current disposition detected only 1 patient requiring geriatric care (p = 0.09). Further, it decreased regular hospitalizations considerably (32 vs. 64, p < 0.001). Conclusions: The novel risk based biomarker enhanced disposition is an objective, safe and probably more efficient disposition system to identify outpatient treatment options than the current practice at the University Hospital of Basel.

Item Type: Article
Subjects: STM Digital Press > Medical Science
Depositing User: Unnamed user with email support@stmdigipress.com
Date Deposited: 07 Jan 2023 10:20
Last Modified: 24 May 2024 06:29
URI: http://publications.articalerewriter.com/id/eprint/12

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