A-DROP Scoring System in Predicting Mortality within 30 Days of Hospitalization in Community-acquired Pneumonia Patients at H. Adam Malik General Hospital Medan

Abstract

BACKGROUND: Community-acquired pneumonia (CAP) is the leading cause of death among infectious diseases, contributing significantly to patient morbidity and mortality. Therefore, an accurate initial assessment of CAP severity should be performed immediately to determine the prognosis before starting the management. A-DROP scoring system is one of the initial assessments. AIM: This study aimed to determine the accuracy of the A-DROP scoring system in predicting mortality within 30 days of hospitalization at H. Adam Malik General Hospital Medan. METHODS: This is an observational study with a retrospective and cohort study. Data were obtained from the medical records of 76 CAP patients hospitalized from January 2018 to December 2018. Each patient was assessed with an A-DROP scoring system and the presence or absence of mortality within 30 days of hospitalization. The data were processed using statistical analysis to calculate the area under curve (AUC) on the receiver operating characteristic (ROC) curve. The optimal cutoff point is also analyzed using the Youden index. RESULT: The ROC curve analysis showed that the AUC was 0.772 (95% CI: 0.666–0.978, p < 0.001). The accuracy of A-DROP scoring system is good (AUC:0.7−0.8). The optimal of the Youden index is 0.428 at the cutoff point A-DROP score >1.5, so that the optimal cutoff point is A-DROP score ≥2. CONCLUSION: The A-DROP scoring system has good accuracy in predicting mortality within 30 days of hospitalized CAP patients. The A-DROP scoring system has an accuracy similar to the PSI (Pneumonia Severity Index) and the CURB-65 scoring system.