Abstract
Background
Risk scores play a crucial role in assessing mortality risk among patients diagnosed with community-acquired pneumonia (CAP). Despite their practicality, there remains a dearth of comparative evidence regarding various risk scoring systems.
Methods
This multicenter retrospective study was conducted across two high-complexity medical institutions, focusing on individuals diagnosed with CAP. Receiver Operating Characteristic (ROC) curves were generated to assess the predictive performance of each analyzed risk score questionnaire in predicting survival or death at 3, 6, and 12 months post-diagnosis.
Results
Out of a total of 7454 potentially eligible patients, 3688 were included in the final analysis. Survival at 3, 6, and 12 months was 94.8%, 91.7% and 83.7%, respectively. At 3 months, PSI, CHARLSON, and CRB-65 scores showed ROC curves of 0.74 (95% CI: 0.71–0.77), 0.71 (95% CI: 0.67–0.74), and 0.7 (95% CI: 0.66–0.74). At 6 months, PSI and CHARLSON scores showed performances of 0.74 (95% CI: 0.72–0.77) and 0.72 (95% CI: 0.69–0.74), respectively. At 12 months, all evaluated scores showed poor discriminatory capacity, including PSI, which decreased its capacity to poor with an ROC curve of 0.64 (95% CI: 0.61–0.66).
Conclusion
In predicting mortality in patients with CAP, it was observed that at 3 months, PSI, CHARLSON, and CRB-65 showed acceptable predictive performances. At 6 months, only PSI and CHARLSON maintained acceptable levels of accuracy. For the 12-month period, all evaluated scores exhibited very limited discriminatory ability, ranging from poor to almost negligible.