Comparative Evaluation of Severity Scoring Systems for Predicting Clinical Outcomes in Community-Acquired Pneumonia

Authors

  • Arif Mehmood Department of Medicine, Aziz Fatimah Hospital, Faisalabad - Pakistan
  • Awais Aslam Department of Pulmonology, Aziz Fatimah Hospital, Faisalabad - Pakistan
  • Farhat Noor Department of Medicine, Aziz Fatimah Hospital, Faisalabad - Pakistan
  • Absar Aslam Department of Medicine, Aziz Fatimah Hospital, Faisalabad - Pakistan
  • Alam Noor Department of Pulmonology, Aziz Fatimah Hospital, Faisalabad - Pakistan

Keywords:

Intensive Care Unit, Community-Acquired Pneumonia, Six Severity Scoring Systems

Abstract

Background: Community-acquired pneumonia (CAP) continues to be a leading cause of morbidity and mortality globally, particularly among hospitalized patients. The timely recognition of high-risk individuals is essential to facilitate management decisions. A number of severity scoring systems have been created to assist with predictions of clinical outcomes. However, the greater relative predictive accuracy of each severity score is still the subject of current research. Objective: To formally compare scoring systems of CAP for predictive measures of mortality, intensive care unit (ICU) admission, need for mechanical ventilation, and need for vasopressors. Methodology: This observational study was performed at Aziz Fatimah Hospital, Faisalabad with 92 adult patients with community-acquired pneumonia. Patients were evaluated for age, sex, clinical signs and symptoms, lab values, and radiological data. Scoring systems for the CAP severity (PSI, CURB-65, CORB, CRSI-65, SCAP, SMART-COP) were calculated for every patient. Results: In total, 92 patients were included in the study. Greater severity scores were significantly associated with in hospital mortality, intensive care unit (ICU) admission, mechanical ventilation, and vasopressor use. SCAP and SMART-COP had the highest sensitivity and specificity for most outcomes. All six scoring systems had statistically significant predictive value (p < 0.05) across some or all of the outcomes. Conclusion: SCAP and SMART-COP were consistently reliable scoring systems for predicting adverse outcomes for patients with CAP. The PSI had good sensitivity for mortality, but was less useful for rapid triage. CURB-65 and CORB had moderate predictive value. The use of an appropriate scoring system can assist timely assessment of risk and clinical decision-making.

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Published

2025-03-02

How to Cite

Mehmood, A. ., Aslam, A. ., Noor, F. ., Aslam, A. ., & Noor, A. . (2025). Comparative Evaluation of Severity Scoring Systems for Predicting Clinical Outcomes in Community-Acquired Pneumonia. Pakistan Journal of Chest Medicine, 31(1), 59–66. Retrieved from https://pjcm.net/index.php/pjcm/article/view/1012

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Vol. 31 No. 1 (2025)

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Original Article

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