Faculty of Medicine
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Item type:Publication, COMPARISON OF THREE SEVERITY SCORING MODELS FOR MORTALITY PREDICTION OF COMMUNITY-ACQUIRED PNEUMONIA(Peytchinski Publishing Ltd., Pleven, Bulgaria, 2024-10); ; ;Rangelov, Goran; Cana, FadilIntroduction: Community-acquired pneumonia (CAP) is among the leading cause of morbidity and mortality worldwide. Several scoring models have been developed to accurately asses a disease severity and early to predict the outcome, however an optimal prognostic tool still is not clearly defined. The aim of this study was to compare three commonly used scores in patients with CAP, in order to determine the best tool that will early identify those with increased risk for mortality. Methods: The study included 129 patients aged ≥18 years with CAP hospitalized at the intensive care unit (ICU) at the University Clinic for Infectious Diseases in Skopje, during a 3-year period. Demographic, clinical and biochemical parameters were recorded and three scores were calculated at admission: SOFA (Sequential Organ Failure Assessment Score), SAPS II (Simplified Acute Physiology Score) and APACHE II (Acute Physiology and Chronic Health Evaluation II). Primary outcome was 30-day in-hospital mortality. Receiver Operating Curve (ROC) analysis was performed and areas under the curve (AUC) were compared to evaluate mortality prediction capacities of the scores. Results: The mean age of the patients was 61 year, predominantly were males (66,7%), most (79,1%) had co-morbid condition and Charlson Comorbidity index was significantly increased in non-survivors. An overall mortality was 43.4%. All severity scores had higher values in patients who died, that was statistically significant with the outcome. The AUC values of the scores were 0,749 for SOFA, 0.749 for SAPS II and 0.714 for APACHE II, showing similar prediction ability. Conclusion. Commonly used severity scoring models accurately identified patients with CAP that had an increased risk for poor outcome, but none of them showed to be superior over the others in ability to predict the mortality. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of severity scoring systems in patients with severe community acquired pneumonia("N Gh Lupu" Foundation of Internal Medicine and Romanian Academy, 2021-12); ; ; ; Background. The aim of this study was to evaluate the ability of severity scoring systems to predict 30-day mortality in patients with severe community-acquired pneumonia. Methods. The study included 98 patients aged ≥18 years with community acquired pneumonia hospitalized at the Intensive Care Unit of the University Clinic for Infectious Diseases in Skopje, Republic of North Macedonia, during a 3-year period. We recorded demographic, clinical and common biochemical parameters. Five severity scores were calculated at admission: CURB 65 (Confusion, Urea, Respiratory Rate, Blood pressure, Age ≥65 years), SCAP (Severe Community Acquired Pneumonia score), SAPS II (Simplified Acute Physiology Score), SOFA (Sequential Organ Failure Assessment Score) and MPM (Mortality Prediction Model). Primary outcome variable was 30-day in-hospital mortality. Results. The mean age of the patients was 59.08 ± 15.76 years, predominantly males (68%). The overall 30-day mortality was 52%. Charlson Comorbidity index was increased in non-survivors (3.72 ± 2.33) and was associated with the outcome. All severity indexes had higher values in patients who died, that showed statistical significance between the analysed groups. The areas under curve (AUC) values of the five scores for 30-day mortality were 0.670, 0.732, 0,726, 0.785 and 0.777, respectively. Conclusion. Widely used severity scores accurately detected patients with pneumonia that had increased risk for poor outcome, but none of them individually demonstrated any advantage over the others. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Identification of risk factors for lethal outcome in patients with severe community-acquired pneumonia(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2020); ; ; ;Denkovska EAim of the study. To determine clinical and biochemical parameters as risk factors for mortality in patients with severe community-acquired pneumonia. Material and methods. A prospective, parallel group analysis of patients with community-acquired pneumonia, treated at the Intensive Care Unit of the University Clinic for Infectious Diseases in period of one year. A total of 42 adults (>=18 years) were enrolled, who were divides in two groups according to the outcome; survived and deceased. The outcome was defined as survival or death during the 30-day hospital treatment. Demographic, clinical as well as laboratory parameters were evaluated in all patients on admission. A statistically significant finding was considered if p<0,05. Results: The average age of patients was 61+15.2 years, and 33 (78.6%) were males. The overall mortality was 50%. In 29 (69%) patients a comorbid condition was registered, and comorbidity showed a statistical significance regarding the outcome. All had tachycardia, tachypnea and hypotension on admission, but impaired consciousnesses and shock were associated with mortality. Patients who died had a higher leukocyte count (15.9+11.8x109/L), higher procalcitonin levels (43.9+77.3 mg/ml), higher serum glucose levels (11.4+6.2 mmol/L) and lower PaO2/Fi O2 (122.64+ 52.8). Hyperglycaemia and hypoxia were the biochemical parameters that showed a statistically significant difference between the two study groups. Conclusion: Early identification of the risk factors for lethal outcome in patients with severe community acquired pneumonia enables implementation of adequate therapeutic measures, thereby decreasing the mortality in this group of critically ill patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Initial empiric antimicrobial treatment of Chlamydia pneumoniae: a study of 54 cases in the Republic of Macedonia(Macedonian Academy of Sciences and Arts, 2006-07-27); ;Dimitriev, Dimitar; ;Anastasovska, Ankica
