Volume 7 Issue 3
May  2016
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Li Zhibin, Zhang Geng, Ma Shuaijun, et al. Comparison of application value of three pulmonary infection scoring systems in pulmonary infection after renal transplantation[J]. ORGAN TRANSPLANTATION, 2016, 7(3): 196-200. doi: 10.3969/j.issn.1674-7445.2016.03.007
Citation: Li Zhibin, Zhang Geng, Ma Shuaijun, et al. Comparison of application value of three pulmonary infection scoring systems in pulmonary infection after renal transplantation[J]. ORGAN TRANSPLANTATION, 2016, 7(3): 196-200. doi: 10.3969/j.issn.1674-7445.2016.03.007
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Comparison of application value of three pulmonary infection scoring systems in pulmonary infection after renal transplantation

doi: 10.3969/j.issn.1674-7445.2016.03.007

  • Department of Urology, Xijing Hospital, the Fourth Military Medical University, Xi'an 710032, China

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  • Corresponding author: Yuan Jianlin, Email:jianliny@fmmu.edu.cn
  • Received Date: 2015-01-28
    Available Online: 2021-01-19
  • Publish Date: 2016-05-15
    Abstract
  •   Objective  To compare the performance of PSI, CURB-65 and SMART-COP systems in evaluating the severity and predicting the prognosis of pulmonary infection after renal transplantation.   Methods  Clinical data of 71 patients with pulmonary infection after renal transplantation in Xijing Hospital from January 2009 to June 2015 were retrospectively analyzed. All patients were divided into the severe (n=27) and mild infection groups (n=44). According to the risk-stratification criteria of three scoring systems, all patients were assigned into the low-risk group and moderate-high risk group. The fatality rate, utilization rate of respirator, occupancy rate of intensive care unit (ICU) and length of hospital stay were statistically compared among different risk groups of three scoring systems. The differences among the scores of three systems were compared between the severe and mild infection groups. The efficacy of three scoring systems in predicting the fatality rate of pulmonary infection patients was assessed by receiver operating characteristic (ROC) curve.   Results  By using three scoring systems, the fatality rate, utilization rate of respirator and occupancy rate of ICU in the moderate-high risk groups were significantly higher than those in the low-risk group (all P < 0.05). The length of hospital stay in the moderate-high risk group was significantly longer than that in the low-risk group (P < 0.05). The scores of PSI, CURB-65 and SMART-COP systems in the severe infection group were considerably higher than those in the mild infection group (all P < 0.05). The optimal cut-off scores of PSI, CURB-65 and SMART-COP systems were 75, 1.5 and 3.5, respectively. The sensitivity, specificity and AUC of PSI, CURB-65 and SMART-COP systems in predicting the fatality rate were calculated as 0.929, 0.890, 0.909; 0.857, 0.772, 0.844; 0.929, 0.860, 0.941, respectively.  Conclusions  PSI, CURB-65 and SMART-COP systems can assess the severity of pulmonary infection and predict the fatality rate after renal transplantation. SMART-COP possesses the highest accuracy in predicting the fatality rate. PSI is most sensitive but difficult to implement. CURB-65 is simple and convenient to apply in clinical practice.

     

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