Comparison of the Performance of the CURB-65, A-DROP, and NEWS Scores for the Prediction of Clinical Outcomes in Pneumonia

Abstract

Objectives This study aimed to compare the performance of the CURB-65, A-DROP, and NEWS scores for the prediction of clinical outcomes in patients with community-acquired pneumonia (CAP) in a Colombian population. Materials and Methods In this retrospective cohort study, we analyzed data from patients with CAP seen within the emergency department, general ward hospitalization, and intensive care unit in a tertiary care health institution located in Cundinamarca, from January 2012 to December 2020. Results A total of 1651 patients were included in our study. CURB-65 and A-DROP scores showed a good performance for primary outcomes related to in-hospital mortality and 30-day mortality with an area under the receiver operating characteristic curve (AUC-ROC) of 0.72 (95% confidence interval [CI], 0.69–0.76) and 0.69 (95% CI, 0.65–0.73), respectively. On the other hand, NEWS score exhibited an acceptable performance in predicting in-hospital mortality and 30-day mortality; furthermore, it showed better performance in anticipating the need for invasive mechanical ventilation and vasopressor therapy (AUC-ROC of 0.64 [95% CI, 0.59–0.69] and AUC-ROC of 0.65 [95% CI, 0.60–0.69], respectively). Conclusions Our findings suggest that, in patients with CAP, the use of CURB-65, A-DROP, and NEWS scores helps the clinician to predict in-hospital and 30-day mortality. However, NEWS score proves to be a more convenient tool to predict the need for several life support measures and management in the intensive care unit.