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Revision of the severity rating and classification of hospital-acquired pneumonia in the Japanese Respiratory Society guidelines.

机译：根据日本呼吸学会指南修订了医院获得性肺炎的严重程度分级和分类。

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BACKGROUND AND OBJECTIVE: Based on the results of a multicentre collaborative survey of hospital-acquired pneumonia (HAP) conducted in Japan, the severity rating and classification of pneumonia in the Japanese Respiratory Society guidelines for management of HAP were examined. METHODS: Parameters for the severity classification were selected from the factors associated with prognosis in the HAP survey and in other previous reports. Depending on the presence of the parameters listed below, patients with HAP were stratified into those with high, moderate or low-risk. The high-risk group was defined as patients with three or more of the following risk factors: 'malignant tumour or immunocompromised status', 'impaired consciousness', 'requiring fraction of inspired oxygen (FiO(2)) > 35% to maintain SaO(2) > 90%', 'man aged 70 years or older, or woman aged 75 years or older' and 'oliguria or dehydration.' The moderate-risk group was defined as patients with any of the secondary risk factors as follows: 'CRP> or = 200 mg/L' and 'extent of infiltration on CXR covers at least 2/3 of one lung'. The low-risk group was defined as all other patients. RESULTS: Application of this classification scheme to the patients enrolled in the HAP survey revealed a mortality rate of 40.8% (98/240) in the high-risk group, which was significantly higher than the mortality rates in the moderate and low-risk groups: 24.9% (69/277) and 12.1% (101/834), respectively. CONCLUSION: These results indicate that it is possible to classify patients using these parameters as prognostic indicators.
机译：背景与目的：根据日本对医院获得性肺炎（HAP）进行的多中心协作调查的结果，检查了日本呼吸学会HAP管理指南中的肺炎严重程度分级和分类。方法：从HAP调查和其他先前报告中与预后相关的因素中选择严重性分类的参数。根据以下所列参数的存在，将HAP患者分为高，中或低风险患者。高风险组定义为具有以下三个或三个以上危险因素的患者：“恶性肿瘤或免疫功能低下状态”，“意识障碍”，“需要吸入氧气的分数（FiO（2））> 35％才能维持SaO” （2）>“ 90％”，“ 70岁以上的男性或75岁以上的女性”和“少尿或脱水”。中度风险组定义为具有以下任何次要危险因素的患者：“ CRP>或= 200 mg / L”和“ CXR浸润程度覆盖至少2/3的一只肺”。低风险组定义为所有其他患者。结果：将这种分类方案应用于参加HAP调查的患者，发现高危组的死亡率为40.8％（98/240），显着高于中低危组的死亡率：分别为24.9％（69/277）和12.1％（101/834）。结论：这些结果表明可以使用这些参数作为预后指标对患者进行分类。

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