Objective:We aimed to assess the performance of common pneumonia severity scores, such as pneu-monia severity index (PSI), CURB-65, CRB-65, A-DROP, and SMART-COP, in predicting adverse outcomesin elderly community-acquired pneumonia cohort and to determine the optimal scoring system forspecific outcomes of interest. Methods:A total of 822 elderly inpatients were included in the retrospective cohort study. Clinical andlaboratory results on admission were used to calculate the above scores. The primary outcome was 30-day mortality. Secondary outcomes were in-hospital mortality, need for mechanical ventilation (MV) andICU admission. Model discrimination was evaluated by the area under receiver operating characteristiccurves (AUCs). Results:The 30-day and in-hospital mortality rates were 6.8% (56/822) and 8.6% (71/822), respectively.One hundred and ninety-eight (24.0%) received MV and 111 (13.5%) were admitted to the ICU. Allfivescoring systems showed the same trend of increasing rates of each adverse outcome with increasing riskgroups (all p<0.001). PSI had the highest AUC, sensitivity, and negative predictive value (NPV) inpredicting 30-day mortality and in-hospital mortality. SMART-COP had the highest AUC for predictingthe need for MV and ICU admission, but PSI had the highest sensitivity and NPV for these two outcomes. Discussion:PSI performed well in identifying elderly patients at risk for 30-day mortality and its highNPV is helpful in excluding patients who are not at risk. Considering their effectiveness and simplicity,SMART-COP and CURB-65 are easier to perform in clinical practice than PSI.Lixue Huang, Clin MicrobiolInfect 2024;30:1426
[1]Chinese Acad Med Sci, Beijing Hosp, Inst Geriatr Med, Natl Ctr Gerontol,Dept Pulm Crit & Care Med, Beijing 100730, Peoples R China.
[2]Chinese Acad Med Sci, Inst Resp Med,Ctr Resp Med, China Japan Friendship Hosp,State Key Lab Resp Hlt, Dept Clin Res & Data Management,Natl Ctr Resp Med,, Beijing, Peoples R China.
(8.0+极速模式)