Respiratory infections are the most common of all infections and of these pneumonia is the most serious infection with high mortality.The aim of our study was to test the validity of pneumonia severity index (PSI) and CURB-65 severity scoring systems in community acquired pneumonia in an Indian setting.
This study was a hospital based prospective study comprising 150 patients of a tertiary care institute in an urban area of Kashmir, India. The patients selected were the cases of community acquired pneumonia (CAP).
The sensitivity and specificity are most favourable for a CURB-65 class ≥III. The sensitivity and specificity are most favourable for a PSI class ≥IV. Although both CURB-65 class ≥III and PSI class ≥IV are 100% sensitive in predicting death, CURB-65 class ≥III has a higher specificity (74.6%) than PSI class ≥IV (52.2%) when used to predict death. In both PSI and CURB-65 risk scoring systems, mortality rates, need for intensive care unit (ICU) admission, prolonged need for antibiotics prolonged duration of hospital stay and need for admission to ICU increased progressively with increasing scores however PSI class ≥IV is more sensitive in predicting ICU admission than CURB-65. The duration of hospital stay was found was found to have a weak but significant correlation with PSI and CURB65 criteria. Defervescence time also had a very weak but significant correlation with PSI and CURB65 criteria. Duration of IV antibiotics had a moderately strong correlation with CURB65 criteria but a weak correlation with PSI Criteria.
Both PSI and CURB-65 have equal sensitivity to predict death from CAP, however specificity of CURB-65 is higher than that of PSI. However, PSI is more sensitive in predicting ICU admission than CURB-65.
By using the knowledge of these criteria, patients of CAP can be better prognosticated as regards to severity of their illness with consequently better triaging of patients, utilization of resources and appropriate treatment to improve the outcome in this disease.
Naveed Shah, No Financial Disclosure Information; No Product/Research Disclosure Information