Oxy-Met score: a new physiological index to predict mortality in community-acquired pneumonia

Abstract

Background: The rapid and objective assessment of the impact of pneumonia on oxygenation and metabolic status may be a useful prognostic tool in this disease. The aim of this work was to assess the accuracy of a new analytical score “Oxy-Met” as a predictor of ICU admission and mortality in community-acquired pneumonia (CAP). Methods: We designed a qualitative Oxy-Met score as the combination of the oxygenation status assessment (PaO2/FiO2) plus metabolic disturbances (sodium 250 mg/dl and blood urea >11 mmol/L). We analyzed the accuracy of Oxy-Met score compared to PSI to predict ICU admission and mortality. We used X2 test and ROC curves to compare severity scores and outcomes. Results: We analyzed 1627 CAP patients. 8.7% required ICU admission and the global mortality was 5.8%. Factors independently associated with mortality were: Sodium 11 mmol/L, glycemia>250 mg/dl, PaO2/FiO2 11 mmol/L, glycemia>250). The ability to predict ICU admission was higher for Oxy-Met score compared to PSI (AUC 0.732 vs 0.691; p Conclusions: The accuracy of ICU admission prediction of Oxy-Met score is higher than PSI. The use of an index that includes the state of oxygenation and basic metabolic parameters (Oxy-Met) may be as useful as the PSI in the assessment of mortality in CAP.