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Table 4 Performance of the ALL-COP SCORE for predicting severe adverse events in validation cohort subgroups

From: A prediction rule for severe adverse events in all inpatients with community-acquired pneumonia: a multicenter observational study

Subgroups

n

Severe adverse events*, n (%)

Sensitivity, % (95% CI)

Specificity, % (95% CI)

PPV, % (95% CI)

NPV, % (95% CI)

PLR (95% CI)

NLR (95% CI)

AUROC (95% CI)

Patients without potential treatment restriction†

342

57 (16.7)

91.2 (81.1–96.2)

70.5 (65.0–75.5)

38.2 (30.5–46.6)

97.6 (94.4–99.0)

3.1 (2.5–3.8)

0.1 (0.1–0.3)

0.89 (0.84–0.94)

CAP excluding HCAP‡

437

71 (16.2)

94.4 (86.4–97.8)

65.0 (60.0–69.7)

34.3 (28.1–41.3)

98.4 (95.8–99.4)

2.7 (2.3–3.1)

0.1 (0.0–0.2)

0.88 (0.84–0.92)

HCAP§

206

49 (23.8)

87.8 (75.8–94.3)

48.4 (40.7–56.2)

34.7 (26.9–43.4)

92.7 (84.9–96.6)

1.7 (1.4–2.0)

0.3 (0.1–0.5)

0.78 (0.70–0.85)

Patients without requirement of invasive MV/VS at admission||

629

106 (16.9)

91.5 (84.7–95.5)

60.0 (55.8–64.2)

31.7 (26.7–37.1)

97.2 (95.0–98.5)

2.3 (2.0–2.6)

0.1 (0.1–0.3)

0.84 (0.80–0.88)

Patients without immunosuppression**

585

105 (17.9)

91.4 (84.5–95.4)

60.0 (56.0–64.7)

33.6 (28.3–39.2)

97.0 (94.4–98.4)

2.3 (2.0–2.6)

0.1 (0.1–0.3)

0.84 (0.80–0.88)

  1. Definition of abbreviations: CI, confidence interval; PPV, positive predictive value; NPV, negative predictive value; PLR, positive likelihood ratio; NLR, negative likelihood ratio; AUROC, area under the receiver operating characteristic curve; CAP, community-acquired pneumonia; HCAP, healthcare-associated pneumonia; MV, mechanical ventilation; VS, vasopressor support
  2. *Severe adverse events included death and requirement of mechanical ventilation (invasive or noninvasive) or vasopressor support within 30 days after pneumonia diagnosis
  3. †Patients without potential treatment restriction were defined as those under 80 years and without nonambulatory status (who were able to walk)
  4. ‡CAP excluding HCAP was defined as pneumonia that did not match the criteria for hospital-acquired pneumonia (pneumonia occurring 48 h or more after hospital admission)
  5. §HCAP was defined as pneumonia co-occurring with any of the following conditions: hospitalization for 2 days or more during the preceding 90 days, residence in a nursing home or extended care facility, home intravenous therapy (including antibiotics and chemotherapy), chronic dialysis (including hemodialysis and peritoneal dialysis) during the preceding 30 days, or home wound care during the preceding 30 days
  6. ||Patients who required invasive MV/VS at admission were excluded
  7. **Immunosuppression included any immunosuppressive diseases, such as congenital or acquired immunodeficiency, hematologic diseases, asplenia and neutropenia (< 1000 cells/μL), treatment with immunosuppressive agents, chemotherapy within the previous 30 days, or corticosteroids in daily doses of at least 10 mg/day of a prednisone equivalent for more than 2 weeks
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BMC Pulmonary Medicine

ISSN: 1471-2466

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