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• W2796235916 abstract "Abstract Objective To assess community‐acquired pneumonia severity scores from two perspectives: (i) prediction of ICU admission or mortality; and (ii) utility of low scores for prediction of discharge within 48 h, potentially indicating suitability for short‐stay unit admission. Methods Patients with community‐acquired pneumonia were identified from a prospective database of emergency patients admitted with infection. Pneumonia severity index (PSI), CURB‐65, CORB, CURXO, SMARTCOP scores and the Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) minor criteria were calculated. Diagnostic accuracy statistics (sensitivity, specificity, predictive values, likelihood ratios and area under receiver operating characteristic curves [AUROC]) were determined for both end‐points. Results Of 618 patients admitted with community‐acquired pneumonia judged eligible for invasive therapies, 75 (12.1%) were admitted to ICU or deceased at 30 days, and 87 (14.1%) were discharged within 48 h. All scores effectively stratified patients into categories of risk. For prediction of severe pneumonia, SMARTCOP, CURXO and IDSA/ATS discriminated well (AUROC 0.84–0.87). SMARTCOP and CURXO showed optimal sensitivity (85% [95% confidence interval (CI) 75–92]), while specificity was highest for CORB and CURB‐65 (93% and 94%, respectively). Using lowest risk categories for prediction of discharge within 48 h, only SMARTCOP and CURXO showed specificity >80%. PSI demonstrated highest positive predictive value (31% [95% CI 24–39]) and AUROC (0.74 [95% CI 0.69–0.79]). Conclusions Community‐acquired pneumonia severity scores had different strengths; SMARTCOP and CURXO were sensitive with potential to rule out severe disease, while the high specificity of CORB and CURB‐65 facilitated identification of patients at high risk of requirement for ICU. Low severity scores were not useful to identify patients suitable for admission to short‐stay units." @default.
• W2796235916 created "2018-04-13" @default.
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• W2796235916 date "2018-04-02" @default.
• W2796235916 modified "2023-10-14" @default.
• W2796235916 title "Utility of community-acquired pneumonia severity scores in guiding disposition from the emergency department: Intensive care or short-stay unit?" @default.
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• W2796235916 doi "https://doi.org/10.1111/1742-6723.12947" @default.
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