Development and validation of a risk score to predict community-acquired pneumonia occurrence in the adult population
Serra-Prat, Mateu (Consorci Sanitari del Maresme)
Lavado Cuevas, Angel (Consorci Sanitari del Maresme)
Bolibar i Ribas, Ignasi (Institut de Recerca Sant Pau)
Palomera, Elisabet (Consorci Sanitari del Maresme)
Almirall i Pujol, Jordi (Grup d'Estudi al Maresme de la Pneumònia Adquirida a la Comunitat i la MPOC (GEMPAC))
Universitat Autònoma de Barcelona

Data:	2025
Resum:	Background: Community-acquired pneumonia (CAP) preventive strategies can benefit from a quantification of individual CAP risk. This study develops and validates a CAP Risk Score (CAP-RS) for the adult population to predict CAP occurrence in the next five years. Methods: The development phase was as follows: a population-based case-control study to identify potential CAP risk factors for inclusion in the CAP-RS after weighting according to odds ratios; development of a numerical scoring system for weighted risk factors; and establishment of cut-off points to discriminate between different risk levels. The validation phase consisted of a population-based case-control study and a retrospective cohort study (with 47 836 adults aged ≥18 years corresponding to three Maresme (Barcelona) primary care centres) followed up over a five-year period (2015-2019). Results: 786 new CAP cases were identified. 15 factors were included in the CAP-RS. Risk was higher in subjects with CAP than without CAP (4. 5 vs 1. 9; p < 0. 001), and the association (OR) between the CAP-RS and the occurrence of CAP increased as the CAP-RS value increased. AUC-ROC was 0. 67 (p < 0. 001). Cut-offs were established at <1, <5, and <10 points as best discriminating between risk groups. Annual CAP incidence was 1. 9, 3. 1, 6. 2, and 12. 4 new cases/10 inhabitants for the no, moderately, severely, and very severely increased risk groups, respectively. Significant differences in CAP-free survival were observed between the four CAR-RS categories. Conclusions: The 15-item CAP-RS, which stratifies risk with good validity, can aid in the design and implementation of preventive CAP strategies for adult populations.
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Community-acquired pneumonia ; Risk score ; Risk factor ; Prevention ; Validation
Publicat a:	Respiratory investigation, Vol. 63 Núm. 4 (july 2025) , p. 542-547, ISSN 2212-5353

DOI: 10.1016/j.resinv.2025.04.012
PMID: 40288222

6 p, 1.7 MB

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