Fei et al developed a simple prediction rule for evaluating an HIV-positive patient with Pneumocystis pneumonia at presentation. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of California at San Francisco.
Patient selection: HIV-positive patient with Pneumocystis pneumonia at presentation
Parameters:
(1) age in years
(2) serum albumin in g/dL
(3) alveolar-arterial oxygen gradient in mm Hg
(4) recent injection drug use
(5) total serum bilirubin
|
Parameter |
Finding |
Points |
|
age in years |
< 40 years of age |
0 |
|
|
>= 40 years of age |
1 |
|
serum albumin |
>= 3.0 g/dL |
0 |
|
|
< 3.0 g/dL |
1 |
|
alveolar-arterial oxygen gradient |
< 50 mm Hg |
0 |
|
|
>= 50 mm Hg |
1 |
|
recent injection drug use |
no |
0 |
|
|
yes |
1 |
|
total serum bilirubin |
<= 0.6 mg/dL |
0 |
|
|
> 0.6 mg/dL |
1 |
score 1 =
= SUM(points for first 3 parameters)
score 2 =
= SUM(points all 5 parameters)
Interpretation:
• minimum score 1or score 2: 0
• maximum score 1: 3
• maximum score 2: 5
• The higher the score the greater the mortality.
|
Total Score 1 |
Mortality Rate |
|
0 |
0% |
|
1 or 2 |
9% |
|
3 |
41% |
|
Total Score 2 |
Mortality Rate |
|
0 or 1 |
4% |
|
2 or 3 |
12% |
|
4 or 5 |
48% |
Specialty: Infectious Diseases
ICD-10: ,
