Performance of PSI, CURB-65, and SCAP scores in predicting the outcome of patients with community-acquired and healthcare-associated pneumonia.
The objective was to compare three score systems, pneumonia severity index (PSI), the Confusion-Urea-Respiratory Rate-Blood pressure-65 (CURB-65), and severe community-acquired pneumonia (SCAP), for prediction of the outcomes in a cohort of patients with community-acquired (CAP) and healthcare-associated pneumonia (HCAP). Large multi-center, prospective, observational study was conducted in 55 hospitals. HCAP patients were included in the high classes of CURB-65, PSI and SCAP scores have a mortality rate higher than that of CAP patients. HCAP patients included in the low class of the three severity rules have a significantly higher incidence of adverse events, including development of septic shock, transfer into an ICU, and death (p < 0.01). At multivariate Cox regression analysis, inclusion in the severe classes of PSI, CURB-65, or SCAP scores and receipt of an empirical therapy not adherent to international guidelines prove to be risk factors independently associated with poor outcome. PSI, CURB-65, and SCAP score have a good performance in patients with CAP but are less useful in patients with HCAP, especially in patients classified in the low-risk classes.
Department of Public Health and Infectious Diseases, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy. marcofalc@libero.it
Marco
M
Falcone
Salvatore
S
Corrao
Mario
M
Venditti
Pietro
P
Serra
Giuseppe
G
Licata
D001794:Blood Pressure; D017714:Community-Acquired Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D003221:Confusion; D003428:Cross Infection / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D018410:Pneumonia, Bacterial / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D056152:Respiratory Rate; D012720:Severity of Illness Index; D014508:Urea / Q000097:blood
D014508:Urea
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