Pneumonia Severity Index And CURB-65 Scores Are Poor Predictors For Long-Term Mortality In Hospitalized Patients With Community-Acquired Pneumonia

Abstract

The Pneumonia Severity Index (PSI) and CURB-65 scores are well-defined as tools to predict short-term mortality in patients with community-acquired pneumonia (CAP). The role of these scores in predicting long-term mortality is not well defined. The objective of this study was to evaluate the role of PSI and CURB-65 as predictors of long term mortality in patients discharged alive after an episode of CAP. This was a secondary analysis of the University of Louisville Pneumonia Study (ULPS) database. The PSI and CURB-65 were calculated at the time of hospital admission. For patients discharged alive, mortality was evaluated one-year after hospital discharged. Receiver operating characteristic (ROC) analysis was performed to determine the diagnostic performance of the PSI and CURB-65 in predicting long-term mortality. From a total study population of 6,870 patients, 1,744 (25%) patients died within one-year post discharge, and 5,126 (75%) patients were alive one-year post-discharge. Areas under the curve (AUC) for PSI was 0.72 and for CURB-65 was 0.66. Even though the PSI is more accurate than CURB-65, both scores are weak predictors of long-term mortality in hospitalized patients with CAP. Future research studies are necessary to improve the prediction of long-term mortality in hospitalized patients with CAP.