title: Tools for outcome prediction in patients with community acquired pneumonia.
abstract: Community-acquired pneumonia (CAP) is one of the most common causes of mortality world-wide. The mortality rate of patients with CAP is influenced by the severity of the disease, treatment failure and the requirement for hospitalization and/or intensive care unit (ICU) management, all of which may be predicted by biomarkers and clinical scoring systems. Areas covered: We review the recent literature examining the efficacy of established and newly-developed clinical scores, biological and inflammatory markers such as C-Reactive protein (CRP), procalcitonin (PCT) and Interleukin-6 (IL-6), whether used alone or in conjunction with clinical severity scores to assess the severity of CAP, predict treatment failure, guide acute in-hospital or ICU admission and predict mortality. Expert commentary: The early prediction of treatment failure using clinical scores and biomarkers plays a developing role in improving survival of patients with CAP by identifying high-risk patients requiring hospitalization or ICU admission; and may enable more efficient allocation of resources. However, it is likely that combinations of scoring systems and biomarkers will be of greater use than individual markers. Further larger studies are needed to corroborate the additive value of these markers to clinical prediction scores to provide a safer and more effective assessment tool for clinicians.
authors.affiliation: a Intensive Care Medicine , St James's University Hospital , Dublin , Ireland.
authors.forename: Faheem
authors.initials: F
authors.lastname: Khan
authors.affiliation: a Intensive Care Medicine , St James's University Hospital , Dublin , Ireland.
authors.forename: Mark B
authors.initials: MB
authors.lastname: Owens
authors.affiliation: b Department of Respiratory Medicine , South Texas Veterans Health Care System and the University of Texas Health Science Center at San Antonio , San Antonio , TX , USA.
authors.forename: Marcos
authors.initials: M
authors.lastname: Restrepo
authors.affiliation: c Department of Intensive Care Medicine , Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, Centro Hospitalar de Lisboa Ocidental , Lisbon , Portugal.|d Nova Medical School, CEDOC, New University of Lisbon , Lisbon , Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Povoa
authors.affiliation: a Intensive Care Medicine , St James's University Hospital , Dublin , Ireland.|e Department of Clinical Medicine , Trinity College, Welcome Trust-HRB Clinical Research Facility, St James Hospital , Dublin , Ireland.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Martin-Loeches
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D017714:Community-Acquired Infections / Q000097:blood / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D018410:Pneumonia, Bacterial / Q000097:blood / Q000188:drug therapy / Q000401:mortality*; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers
keywords: APACHE; CURB; Pneumonia; community acquired pneumonia; scores; sepsis; treatment failure