COMPARISON OF THREE SEVERITY SCORING MODELS FOR MORTALITY PREDICTION OF COMMUNITY-ACQUIRED PNEUMONIA
Journal
Journal of IMAB
Date Issued
2024-10
Author(s)
Rangelov, Goran
Cana, Fadil
DOI
10.5272/jimab.2024v30Supplement-14-34
Abstract
Introduction: Community-acquired pneumonia (CAP) is among the leading cause of morbidity
and mortality worldwide. Several scoring models have been developed to accurately asses a
disease severity and early to predict the outcome, however an optimal prognostic tool still is not
clearly defined. The aim of this study was to compare three commonly used scores in patients
with CAP, in order to determine the best tool that will early identify those with increased risk for
mortality. Methods: The study included 129 patients aged ≥18 years with CAP hospitalized at
the intensive care unit (ICU) at the University Clinic for Infectious Diseases in Skopje, during a
3-year period. Demographic, clinical and biochemical parameters were recorded and three scores
were calculated at admission: SOFA (Sequential Organ Failure Assessment Score), SAPS II
(Simplified Acute Physiology Score) and APACHE II (Acute Physiology and Chronic Health
Evaluation II). Primary outcome was 30-day in-hospital mortality. Receiver Operating Curve
(ROC) analysis was performed and areas under the curve (AUC) were compared to evaluate
mortality prediction capacities of the scores. Results: The mean age of the patients was 61 year,
predominantly were males (66,7%), most (79,1%) had co-morbid condition and Charlson
Comorbidity index was significantly increased in non-survivors. An overall mortality was
43.4%. All severity scores had higher values in patients who died, that was statistically
significant with the outcome. The AUC values of the scores were 0,749 for SOFA, 0.749 for
SAPS II and 0.714 for APACHE II, showing similar prediction ability. Conclusion. Commonly
used severity scoring models accurately identified patients with CAP that had an increased risk
for poor outcome, but none of them showed to be superior over the others in ability to predict the
mortality.
and mortality worldwide. Several scoring models have been developed to accurately asses a
disease severity and early to predict the outcome, however an optimal prognostic tool still is not
clearly defined. The aim of this study was to compare three commonly used scores in patients
with CAP, in order to determine the best tool that will early identify those with increased risk for
mortality. Methods: The study included 129 patients aged ≥18 years with CAP hospitalized at
the intensive care unit (ICU) at the University Clinic for Infectious Diseases in Skopje, during a
3-year period. Demographic, clinical and biochemical parameters were recorded and three scores
were calculated at admission: SOFA (Sequential Organ Failure Assessment Score), SAPS II
(Simplified Acute Physiology Score) and APACHE II (Acute Physiology and Chronic Health
Evaluation II). Primary outcome was 30-day in-hospital mortality. Receiver Operating Curve
(ROC) analysis was performed and areas under the curve (AUC) were compared to evaluate
mortality prediction capacities of the scores. Results: The mean age of the patients was 61 year,
predominantly were males (66,7%), most (79,1%) had co-morbid condition and Charlson
Comorbidity index was significantly increased in non-survivors. An overall mortality was
43.4%. All severity scores had higher values in patients who died, that was statistically
significant with the outcome. The AUC values of the scores were 0,749 for SOFA, 0.749 for
SAPS II and 0.714 for APACHE II, showing similar prediction ability. Conclusion. Commonly
used severity scoring models accurately identified patients with CAP that had an increased risk
for poor outcome, but none of them showed to be superior over the others in ability to predict the
mortality.
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