Severity assessment of community9acquired pneumonia in real clinical practice in a multi9profile hospital in Russia

We aimed to assess the criteria used by physicians in routine clinical practice to assess severity of communityacquired pneumonia (CAP) in adults. Methods. A survey of 165 physicians from multi-profile hospitals was performed at six Russian cities. Results. Chest X-ray data were considered by 80% of respondents as an important marker to identify severe / non-severe CAP. Clinical features, comorbidity, laboratory abnormalities, and history data were noted by 78.8%; 66.1%; 55.8% and 23.6% of physicians, respectively. Severe dyspnea or tachypnea and confusion were the most often mentioned clinical criteria of severe CAP (78.8% of respondents for each, respectively). Lung tissue destruction was chosen as radiologic criterion of severe CAP in 80.6% of cases. Hyperleukocytosis and leukopenia were pointed as the most frequent laboratory abnormality related to severe CAP (89.7%). Only 10.3% of respondents used CAP prognostic scales. CAP prognostic scales recommended by national guidelines for adult patients (e.g. PORT ? CURB/CRB-65) were not usually used. Conclusion. Generally, physicians are aware of CAP prognostic criteria and key risk factors of poor prognosis. Additional efforts are needed for more efficient implementation of CAP prognostic scales recommended by national guidelines.