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Performance of risk scores in predicting mortality at 3, 6, and 12 months in patients diagnosed with community-acquired pneumonia

Authors :
Eduardo Tuta-Quintero
Alirio R. Bastidas
Gabriela Guerrón-Gómez
Isabella Perna-Reyes
Daniela Torres
Laura Garcia
Javier Villanueva
Camilo Acuña
Eathan Mikler
Juan Arcila
Nicolas Chavez
Allison Riviera
Valentina Maldonado
María Galindo
María Fernández
Carolina Schloss
Luis Felipe Reyes
Source :
BMC Pulmonary Medicine, Vol 24, Iss 1, Pp 1-11 (2024)
Publication Year :
2024
Publisher :
BMC, 2024.

Abstract

Abstract Background Risk scores (RS) evaluate the likelihood of short-term mortality in patients diagnosed with community-acquired pneumonia (CAP). However, there is a scarcity of evidence to determine the risk of long-term mortality. This article aims to compare the effectiveness of 16 scores in predicting mortality at three, six, and twelve months in adult patients with CAP. Methods A retrospective cohort study on individuals diagnosed with CAP was conducted across two hospitals in Colombia. Receiver Operating Characteristic (ROC) curves were constructed at 3, 6, and 12 months to assess the predictive ability of death for the following scoring systems: CURB-65, CRB-65, SCAP, CORB, ADROP, NEWS, Pneumonia Shock, REA-ICU, PSI, SMART-COP, SMRT-CO, SOAR, qSOFA, SIRS, CAPSI, and Charlson Comorbidity Index (CCI). Results A total of 3688 patients were included in the final analysis. Mortality at 3, 6, and 12 months was 5.2%, 8.3%, and 16.3% respectively. At 3 months, PSI, CCI, 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 0.70 (95% CI: 0.66–0.74). At 6 months, PSI and CCI scores showed performances of 0.74 (95% CI: 0.72–0.77) and 0.72 (95% CI: 0.69–0.74), respectively. Finally at 12 months, all evaluated scores showed poor discriminatory capacity, including PSI, which decreased from acceptable to poor with an ROC curve of 0.64 (95% CI: 0.61–0.66). Conclusion When predicting mortality in patients with CAP, at 3 months, PSI, CCI, and CRB-65 showed acceptable predictive performances. At 6 months, only PSI and CCI maintained acceptable levels of accuracy. For the 12-month period, all evaluated scores exhibited very limited discriminatory ability, ranging from poor to almost negligible.

Details

Language :
English
ISSN :
14712466
Volume :
24
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Pulmonary Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.6240038405d479781fbaf86aeec7788
Document Type :
article
Full Text :
https://doi.org/10.1186/s12890-024-03121-7