Prognostic Value Of Pneumonia Severity Index And CURB-65 Score For Elderly Community Acquired Pneumonia In Different Age Groups

Objective The value of pneumonia severity index and CURB-65 score in evaluating the severity and prognosis of community-acquired pneumonia in the elderly of different age groups(65-79 years old and ≥ 80 years old).Methods A retrospective study of 194 consecutive inpatients with elderly CAP was performed in First Affiliated Hospital of Chongqing Medical University from September to December 2018,according to the age of patients.They were divided into low age group(65-79 years old)and high age group(≥80 years old),including 106 cases in low age group and 88 cases in high age group.We analyzed the general clinical data,calculated the scores of each case,and the 28-day prognosis was used as the clinical observation endpoint to compare the difference in mortality between the two scoring systems with different risk stratification.we drew the receiver-operating characteristic(ROC)curves of the two scoring systems and compared their area under the curve(AUCs)to evaluate the predictive value of severity.Results The 28-day mortality rate was 10.4% in the lower age group and 18.2% in the high age group.The AUCs of the CURB-65 and PSI scores in the low age group was 0.846(95% CI:0.740~0.952)and 0.800(95% CI:0.689~0.910),while the AUCs of the CURB-65 and PSI scores in the high age group was 0.757(95% CI:0.615~0.899),0.705(95% CI:0.580~0.830),respectively.Conclusions The predictive efficacy of the two scoring systems for mortality in elderly CAP patients decreases with age.In younger patients,the high specificity of CURB-65 score is helpful for selecting high-risk patients for intensive treatment and monitoring,and the scoring system is relatively simple,which is more suitable for clinical use.Both scoring systems show slightly worse prognostic value in elderly patients.