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Abstract：
BACKGROUND: Risk scores (RS) evaluate the likelihood of short-term mortality in patients diagnosed with community-acquired pneumonia (CAP). However, there is a scarcity of evidence to determine the risk of long-term mortality. This article aims to compare the effectiveness of 16 scores in predicting mortality at three, six, and twelve months in adult patients with CAP.
METHODS: A retrospective cohort study on individuals diagnosed with CAP was conducted across two hospitals in Colombia. Receiver Operating Characteristic (ROC) curves were constructed at 3, 6, and 12 months to assess the predictive ability of death for the following scoring systems: CURB-65, CRB-65, SCAP, CORB, ADROP, NEWS, Pneumonia Shock, REA-ICU, PSI, SMART-COP, SMRT-CO, SOAR, qSOFA, SIRS, CAPSI, and Charlson Comorbidity Index (CCI).
RESULTS: A total of 3688 patients were included in the final analysis. Mortality at 3, 6, and 12 months was 5.2%, 8.3%, and 16.3% respectively. At 3 months, PSI, CCI, and CRB-65 scores showed ROC curves of 0.74 (95% CI: 0.71-0.77), 0.71 (95% CI: 0.67-0.74), and 0.70 (95% CI: 0.66-0.74). At 6 months, PSI and CCI scores showed performances of 0.74 (95% CI: 0.72-0.77) and 0.72 (95% CI: 0.69-0.74), respectively. Finally at 12 months, all evaluated scores showed poor discriminatory capacity, including PSI, which decreased from acceptable to poor with an ROC curve of 0.64 (95% CI: 0.61-0.66).
CONCLUSIONS: When predicting mortality in patients with CAP, at 3 months, PSI, CCI, and CRB-65 showed acceptable predictive performances. At 6 months, only PSI and CCI maintained acceptable levels of accuracy. For the 12-month period, all evaluated scores exhibited very limited discriminatory ability, ranging from poor to almost negligible.
METHODS: A retrospective cohort study on individuals diagnosed with CAP was conducted across two hospitals in Colombia. Receiver Operating Characteristic (ROC) curves were constructed at 3, 6, and 12 months to assess the predictive ability of death for the following scoring systems: CURB-65, CRB-65, SCAP, CORB, ADROP, NEWS, Pneumonia Shock, REA-ICU, PSI, SMART-COP, SMRT-CO, SOAR, qSOFA, SIRS, CAPSI, and Charlson Comorbidity Index (CCI).
RESULTS: A total of 3688 patients were included in the final analysis. Mortality at 3, 6, and 12 months was 5.2%, 8.3%, and 16.3% respectively. At 3 months, PSI, CCI, and CRB-65 scores showed ROC curves of 0.74 (95% CI: 0.71-0.77), 0.71 (95% CI: 0.67-0.74), and 0.70 (95% CI: 0.66-0.74). At 6 months, PSI and CCI scores showed performances of 0.74 (95% CI: 0.72-0.77) and 0.72 (95% CI: 0.69-0.74), respectively. Finally at 12 months, all evaluated scores showed poor discriminatory capacity, including PSI, which decreased from acceptable to poor with an ROC curve of 0.64 (95% CI: 0.61-0.66).
CONCLUSIONS: When predicting mortality in patients with CAP, at 3 months, PSI, CCI, and CRB-65 showed acceptable predictive performances. At 6 months, only PSI and CCI maintained acceptable levels of accuracy. For the 12-month period, all evaluated scores exhibited very limited discriminatory ability, ranging from poor to almost negligible.
摘要：
背景：风险评分（RS）评估诊断为社区获得性肺炎（CAP）患者短期死亡的可能性。然而,缺乏确定长期死亡风险的证据.本文旨在比较16个分数在预测死亡率方面的有效性。六,成人CAP患者12个月。
方法：在哥伦比亚的两家医院中对诊断为CAP的个体进行了回顾性队列研究。在3、6和12个月时构建受试者工作特征（ROC）曲线，以评估以下评分系统的死亡预测能力：CURB-65，CRB-65，SCAP，CORB,ADROP,新闻,肺炎休克,REA-ICU,PSI,SMART-COP,SMRT-CO,SOAR,qSOFA,SIRS,CAPSI,和Charlson合并症指数(CCI)。
结果：共3688例患者纳入最终分析。3、6和12个月的死亡率为5.2%，8.3%,和16.3%。3个月时,PSI,CCI和CRB-65评分显示ROC曲线为0.74（95％CI：0.71-0.77），0.71（95%CI：0.67-0.74），和0.70（95%CI：0.66-0.74）。6个月时,PSI和CCI得分表现为0.74（95％CI：0.72-0.77）和0.72（95％CI：0.69-0.74），分别。终于在12个月时，所有评估的分数都显示出较差的辨别能力，包括PSI,ROC曲线为0.64（95%CI：0.61-0.66），从可接受下降到较差。
结论：在预测CAP患者的死亡率时，3个月时,PSI,CCI和CRB-65显示出可接受的预测性能。6个月时,只有PSI和CCI保持可接受的精度水平。在12个月期间，所有评估的分数都表现出非常有限的辨别能力，从贫穷到几乎可以忽略不计。
方法：在哥伦比亚的两家医院中对诊断为CAP的个体进行了回顾性队列研究。在3、6和12个月时构建受试者工作特征（ROC）曲线，以评估以下评分系统的死亡预测能力：CURB-65，CRB-65，SCAP，CORB,ADROP,新闻,肺炎休克,REA-ICU,PSI,SMART-COP,SMRT-CO,SOAR,qSOFA,SIRS,CAPSI,和Charlson合并症指数(CCI)。
结果：共3688例患者纳入最终分析。3、6和12个月的死亡率为5.2%，8.3%,和16.3%。3个月时,PSI,CCI和CRB-65评分显示ROC曲线为0.74（95％CI：0.71-0.77），0.71（95%CI：0.67-0.74），和0.70（95%CI：0.66-0.74）。6个月时,PSI和CCI得分表现为0.74（95％CI：0.72-0.77）和0.72（95％CI：0.69-0.74），分别。终于在12个月时，所有评估的分数都显示出较差的辨别能力，包括PSI,ROC曲线为0.64（95%CI：0.61-0.66），从可接受下降到较差。
结论：在预测CAP患者的死亡率时，3个月时,PSI,CCI和CRB-65显示出可接受的预测性能。6个月时,只有PSI和CCI保持可接受的精度水平。在12个月期间，所有评估的分数都表现出非常有限的辨别能力，从贫穷到几乎可以忽略不计。
