Performance of SOAR (systolic blood pressure, oxygenation, age and respiratory rate) scoring criteria in community-acquired pneumonia

a prospective multi-centre study

Deepak N Subramanian, Patrick Musonda, Prasanna Sankaran, Syed M Tariq, Ajay V Kamath, Phyo Kyaw Myint

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: severity assessment in community-acquired pneumonia (CAP) is important as it is associated with significant mortality. In this study, we compared a previously suggested severity assessment rule for CAP- SOAR (systolic blood pressure, oxygenation, age and respiratory rate)- against the CURB-65 criteria.

Methods: we conducted a prospective study in three hospitals in Norfolk and Suffolk, UK. Consecutive patients with CAP were scored for severity with CURB-65 (n = 190), and SOAR (when there was sufficient information, n = 112). Mortality data was collected at 6 weeks.

Results: there were 100 males (53%). The age range was 18–101 years (mean 72 years, median 76 years). Sixty-five (34%) had severe pneumonia by CURB-65, and 56 patients out of 112 (50%) had severe pneumonia by SOAR. Patients with severe CAP were significantly more likely to be older, female, and to have higher urea levels and a lower PaO2:FiO2 ratio on admission. There were a total of 54 deaths during follow-up (33 of these in the SOAR-categorised group). There were 32 deaths (50%) in the severe and 22 deaths (18%) in the non-severe groups by CURB-65. There were 23 deaths (70%) in the severe and 22 deaths (30%) in the non-severe groups by SOAR. For CURB-65, sensitivity, specificity, positive and negative predictive values were 60.6, 72.2, 47.6 and 81.4%. For SOAR, the respective values were 69.7%, 58.2, 41.1 and 82.1%.

Conclusion: SOAR had demonstrably better sensitivity, but lower specificity compared with CURB-65 in this patient cohort. SOAR might be more suitable for assessing disease severity as an alternative or adjunct to CURB-65, particularly in the elderly.
Original languageEnglish
Pages (from-to)94-97
Number of pages4
JournalAge and Ageing
Volume42
Issue number1
Early online date7 Nov 2012
DOIs
Publication statusPublished - Jan 2013

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Respiratory Rate
Pneumonia
Blood Pressure
Sensitivity and Specificity
Mortality
Urea
Prospective Studies

Keywords

  • adolescent
  • adult
  • age factors
  • aged
  • aged, 80 and over
  • community-acquired infections
  • female
  • hospitalization
  • humans
  • male
  • middle aged
  • pneumonia
  • predictive value of tests
  • prognosis
  • prospective studies
  • sensitivity and specificity
  • severity of illness index
  • community-acquired pneumonia
  • severity assessment criteria
  • CURB-65
  • SOAR
  • older people

Cite this

Performance of SOAR (systolic blood pressure, oxygenation, age and respiratory rate) scoring criteria in community-acquired pneumonia : a prospective multi-centre study. / Subramanian, Deepak N; Musonda, Patrick; Sankaran, Prasanna; Tariq, Syed M; Kamath, Ajay V; Myint, Phyo Kyaw.

In: Age and Ageing, Vol. 42, No. 1, 01.2013, p. 94-97.

Research output: Contribution to journalArticle

Subramanian, Deepak N ; Musonda, Patrick ; Sankaran, Prasanna ; Tariq, Syed M ; Kamath, Ajay V ; Myint, Phyo Kyaw. / Performance of SOAR (systolic blood pressure, oxygenation, age and respiratory rate) scoring criteria in community-acquired pneumonia : a prospective multi-centre study. In: Age and Ageing. 2013 ; Vol. 42, No. 1. pp. 94-97.
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abstract = "Background: severity assessment in community-acquired pneumonia (CAP) is important as it is associated with significant mortality. In this study, we compared a previously suggested severity assessment rule for CAP- SOAR (systolic blood pressure, oxygenation, age and respiratory rate)- against the CURB-65 criteria.Methods: we conducted a prospective study in three hospitals in Norfolk and Suffolk, UK. Consecutive patients with CAP were scored for severity with CURB-65 (n = 190), and SOAR (when there was sufficient information, n = 112). Mortality data was collected at 6 weeks.Results: there were 100 males (53{\%}). The age range was 18–101 years (mean 72 years, median 76 years). Sixty-five (34{\%}) had severe pneumonia by CURB-65, and 56 patients out of 112 (50{\%}) had severe pneumonia by SOAR. Patients with severe CAP were significantly more likely to be older, female, and to have higher urea levels and a lower PaO2:FiO2 ratio on admission. There were a total of 54 deaths during follow-up (33 of these in the SOAR-categorised group). There were 32 deaths (50{\%}) in the severe and 22 deaths (18{\%}) in the non-severe groups by CURB-65. There were 23 deaths (70{\%}) in the severe and 22 deaths (30{\%}) in the non-severe groups by SOAR. For CURB-65, sensitivity, specificity, positive and negative predictive values were 60.6, 72.2, 47.6 and 81.4{\%}. For SOAR, the respective values were 69.7{\%}, 58.2, 41.1 and 82.1{\%}.Conclusion: SOAR had demonstrably better sensitivity, but lower specificity compared with CURB-65 in this patient cohort. SOAR might be more suitable for assessing disease severity as an alternative or adjunct to CURB-65, particularly in the elderly.",
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T1 - Performance of SOAR (systolic blood pressure, oxygenation, age and respiratory rate) scoring criteria in community-acquired pneumonia

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AU - Subramanian, Deepak N

AU - Musonda, Patrick

AU - Sankaran, Prasanna

AU - Tariq, Syed M

AU - Kamath, Ajay V

AU - Myint, Phyo Kyaw

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N2 - Background: severity assessment in community-acquired pneumonia (CAP) is important as it is associated with significant mortality. In this study, we compared a previously suggested severity assessment rule for CAP- SOAR (systolic blood pressure, oxygenation, age and respiratory rate)- against the CURB-65 criteria.Methods: we conducted a prospective study in three hospitals in Norfolk and Suffolk, UK. Consecutive patients with CAP were scored for severity with CURB-65 (n = 190), and SOAR (when there was sufficient information, n = 112). Mortality data was collected at 6 weeks.Results: there were 100 males (53%). The age range was 18–101 years (mean 72 years, median 76 years). Sixty-five (34%) had severe pneumonia by CURB-65, and 56 patients out of 112 (50%) had severe pneumonia by SOAR. Patients with severe CAP were significantly more likely to be older, female, and to have higher urea levels and a lower PaO2:FiO2 ratio on admission. There were a total of 54 deaths during follow-up (33 of these in the SOAR-categorised group). There were 32 deaths (50%) in the severe and 22 deaths (18%) in the non-severe groups by CURB-65. There were 23 deaths (70%) in the severe and 22 deaths (30%) in the non-severe groups by SOAR. For CURB-65, sensitivity, specificity, positive and negative predictive values were 60.6, 72.2, 47.6 and 81.4%. For SOAR, the respective values were 69.7%, 58.2, 41.1 and 82.1%.Conclusion: SOAR had demonstrably better sensitivity, but lower specificity compared with CURB-65 in this patient cohort. SOAR might be more suitable for assessing disease severity as an alternative or adjunct to CURB-65, particularly in the elderly.

AB - Background: severity assessment in community-acquired pneumonia (CAP) is important as it is associated with significant mortality. In this study, we compared a previously suggested severity assessment rule for CAP- SOAR (systolic blood pressure, oxygenation, age and respiratory rate)- against the CURB-65 criteria.Methods: we conducted a prospective study in three hospitals in Norfolk and Suffolk, UK. Consecutive patients with CAP were scored for severity with CURB-65 (n = 190), and SOAR (when there was sufficient information, n = 112). Mortality data was collected at 6 weeks.Results: there were 100 males (53%). The age range was 18–101 years (mean 72 years, median 76 years). Sixty-five (34%) had severe pneumonia by CURB-65, and 56 patients out of 112 (50%) had severe pneumonia by SOAR. Patients with severe CAP were significantly more likely to be older, female, and to have higher urea levels and a lower PaO2:FiO2 ratio on admission. There were a total of 54 deaths during follow-up (33 of these in the SOAR-categorised group). There were 32 deaths (50%) in the severe and 22 deaths (18%) in the non-severe groups by CURB-65. There were 23 deaths (70%) in the severe and 22 deaths (30%) in the non-severe groups by SOAR. For CURB-65, sensitivity, specificity, positive and negative predictive values were 60.6, 72.2, 47.6 and 81.4%. For SOAR, the respective values were 69.7%, 58.2, 41.1 and 82.1%.Conclusion: SOAR had demonstrably better sensitivity, but lower specificity compared with CURB-65 in this patient cohort. SOAR might be more suitable for assessing disease severity as an alternative or adjunct to CURB-65, particularly in the elderly.

KW - adolescent

KW - adult

KW - age factors

KW - aged

KW - aged, 80 and over

KW - community-acquired infections

KW - female

KW - hospitalization

KW - humans

KW - male

KW - middle aged

KW - pneumonia

KW - predictive value of tests

KW - prognosis

KW - prospective studies

KW - sensitivity and specificity

KW - severity of illness index

KW - community-acquired pneumonia

KW - severity assessment criteria

KW - CURB-65

KW - SOAR

KW - older people

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DO - 10.1093/ageing/afs158

M3 - Article

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JO - Age and Ageing

JF - Age and Ageing

SN - 0002-0729

IS - 1

ER -