A new scoring system to predict mortality in community-acquired pneumonia: CURB (S)-65.

Abstract

The first decision to be made in the case of community-acquired pneumonia (CAP) is whether hospitalization of the patient is mandatory. In this study, we aimed to investigate whether the addition of oxygenation parameters to CURB-65 has diagnostic value in predicting mortality in CAP. A total of 903 CAP patients were included in the study. Patients with a CURB-65 score of 0 and 1 were classified as Group 1 and patients with a CURB-65 score of 2 or more were classified as Group 2. The prediction of mortality through Pneumonia Severity Index (PSI), CURB-65 and CURBS-65/CURBP-65 with the addition of SaO2 and PaO2 values; hence the four different models, was compared among all patient groups. As a result, 3.3% of the cases in Group 1 and 12.7% of the cases in Group 2 died. In both CURB-65 groups, it was noted that the frequency of patients with SaO2 <90% was significantly higher in the dead group than in the alive patient group (p=0.009 and p=0.001, respectively). In the univariate analysis, PaO2<60, and SaO2<90 were significantly associated with mortality. Model 2 (CURBS-65) and Model 3 (CURBP- 65) were examined, SaO2<90 (OR 2.08) was found to have an effect on death. In predicting mortality by the receiver operating characteristics (ROC) analysis, it was understood that the CURBS-65 score had a slightly higher area under the curve (AUC) value than CURB-65. As a result, it has been shown that the use of CURBS-65 scoring instead of CURB-65 clinical scoring may be more useful in predicting mortality.