PNEUMONIA SEVERITY INDEX COMPARED TO CURB-65 IN PREDICTING THE OUTCOME OF COMMUNITY ACQUIRED PNEUMONIA -A PROSPECTIVE STUDY

Introduction: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Several severity scores have been proposed to guide initial decision making on hospitalization and to predict the outcome. Pneumonia Severity Index (PSI) and CURB 65 are the two most widely used scoring systems to prognosticate pneumonia.

Objectives: Tocompare the efficacy of PSI and CURB 65 scoring systems in prognosticating the outcome in cases of CAP.

Methods: This is a prospective study conducted over a period of one year on 150 patients who presented with community acquired pneumonia on the grounds of their clinical and paraclinical findings in our institution under the Department of respiratory Medicine, and fulfilling the inclusion and exclusion criteria. The patients were classified as per CURB 65 and PSI system and their outcome compared.

Results: We studied 150 patients with community-acquired pneumonia (114 men, 36 women). In our study 100 % of patients in CURB 65 class 4 and 5 required ICU admission and death was 84.6% and 100% respectively. Majority of patients of PSI class 4 and 5 needed ICU admission 67% and 96% respectively and death was 16% and 58% respectively. The sensitivity and specificity of CURB-65 class ≥3 in predicting mortality were 79% and 89%, respectively (AUC 0.92). As for pneumonia severity index class ≥4, the rates were 79% and 84%, respectively (AUC 0.86). The mortality rate and need for ICU admission increased progressively with increasing scores.

Conclusion: CURB-65 seems to be the preferred method to predict mortality and need for ICU admission in patients with community-acquired pneumonia.