A Clinical Study On The Effectiveness Of PSI And CURB-65 Scoring Systems On The Severity Evaluation And Prognosis Prediction Of The Community-acquired Pneumonia In Obese People

Objective: This paper discusses the effectiveness of PSI and CURB-65 scoring systems on the severity evaluation and prognosis prediction of the community-acquired pneumonia in the obese people.Furthermore,it compares the PSI and CURB-65 scoring systems for the clinical predictive value of prognosis for the community-acquired pneumonia in obese people.Methods: Apply the PSI and CURB-65 evaluation on the 196 cases of community-acquired pneumonia patients in our hospital between May 2012 and May 2015.We use CURB-65 scoring system to evaluate patients being hospitalized instantly and PSI scoring system to evaluate patients being hospitalized for 24 hours,respectively.The patients were then divided into three groups,high-risk group,medium-risk group and low-risk group.The effectiveness and clinical predictive value for the three groups was compared and analyzed.Results: Using the CURB-65 evaluation,142 patients were put in the high-risk group with 33 fatal case,which yields a fatality rate of 23.34%.38 patients were in the medium-risk group with 7 fatal cases and fatality rate of 18.42%.16 patients were in the low-risk group with 1 fatal case and fatality rate of 6.25%.There is no statistically significant difference in the fatality rate between the three groups(χ2=5.111,p= 0.195).The PSI evaluation was applied to all the 196 cases.The scoring system put 51 patients into the medium-risk group with 6 fatal cases and the fatality rate is 11.76%.28 patients were put into the low-risk group with one fatal case and a fatality rate of3.57%.117 patients were put in the high-risk group with 34 fatal cases.The fatality rate for the high-risk group is 29.06%,which is much higher than that of the medium-risk and low-risk groups.The difference is significant(χ2=1.679,p<0.001).Among the 196 cases,the fatal cases’ CURB-65 evaluation score was 4.52±0.21 and 4.48±0.43 for the PSI evaluation.Both are significantly higher than the scores for the survival cases,which were 1.13±0.42 under CURB-65 and 1.13±0.42 under PSI.(t=82.4468,p<0.001 for CURB-65;t=79.7278,p<0.001 for PSI).After the evaluation of AUC,the score of PSI was 0.754,and its optimal cutoff point was 4 with 58.80% sensitivity and 78.01% specificity.Correspondingly,the score of CURB-65 was 0.796 and its optimal cutoff point was 3.5 with 88.20% sensitivity and 64.01% specificity.The PSI scoring system has a higher specificity while the CURB-65 scoring system has a better sensitivity.Conclusion: 1.Both the PSI scoring system and the CURB-65 scoring system are both effective for the clinical prediction of prognosis for the community-acquired pneumonia in the obese people.The PSI scoring system has a higher specificity while the CURB-65 scoring system has a better sensitivity.2.The PSI scoring system provides higher value over the prediction of fatality for the community-acquired pneumonia in the obese people.