For patients with community-acquired pneumonia (CAP), determining the severity
and location of care is essential for ensuring their safety and apportion of resources
appropriately. Severity scores can help clinicians fortell the outcome of patients
having CAP.
This study aimed to compare different scoring systems of CAP in predicting
mortality, Intensive Care Unit (ICU) admission, mechanical ventilation, and the
need for vasopressors.
Methods
This was a prospective cohort study carried out at Benha University Hospitals from
March 2022 to March 2023 on 60 patients aged above 18 years (58 ± 16) presented
by CAP. Scores for assessment were the pneumonia severity index (PSI), CURB-
65, CORB, CRSI-65, SCAP, and SMART COP scoring systems.
Results
Higher severity scores were associated with increased mortality, ICU admission,
and Intensive Respiratory and Vasopressor Support (IRVS). SMART COP was the
best score with AUC 0.750 (95% CI: 0.577–0.923) for ICU admission prediction
(cut-off >2, sensitivity 83.3%, P=0.008). SCAP score was the best score with AUC
0.710 (95% CI: 0.579–0.820) for mortality prediction. CORB score (AUC 0.674, cutoff
>1, sensitivity 80.00%, P=0.015) and Severe Community Acquired Pneumonia
score (SCAP score) (AUC 0.711, cut-off >21, sensitivity 80.00%, P=0.002) were
most sensitive in predicted vasopressor use. PSI score was the most sensitive
AUC 0.727 (95% CI: 0.597–0.834) for Mechanical Ventilation (MV) use (cut-off
>115, sensitivity 94.10%, P=0.001).
Conclusion
Severity scoring systems, including PSI, CURB-65, CORB, CRSI 65, SCAP,
and SMART COP, are valuable tools for predicting the severity, mortality, ICU
admission, and the need for MV and vasopressors in patients with CAP. SCAP
score was the most valuable.