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VOLUME 13 , ISSUE 1 ( January-March, 2024 ) > List of Articles

Original Article

A Comparative Study of Confusion, Urea Nitrogen, Respiratory Rate, Blood Pressure, Age ≥ 65 and Pneumonia Severity Index Scoring Systems in Patients with Pneumonia in a Tertiary Care Setting

Naga Vishnu P Kasa, Narendra K Narahari, Nageswara R Modugu

Keywords : CURB, mortality, pneumonia, pneumonia severity index, PSI

Citation Information : Kasa NV, Narahari NK, Modugu NR. A Comparative Study of Confusion, Urea Nitrogen, Respiratory Rate, Blood Pressure, Age ≥ 65 and Pneumonia Severity Index Scoring Systems in Patients with Pneumonia in a Tertiary Care Setting. Indian J Respir Care 2024; 13 (1):15-22.

DOI: 10.5005/jp-journals-11010-1089

License: CC BY-NC 4.0

Published Online: 06-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: Pneumonia is one of the major causes of mortality and morbidity globally. The ability to stratify the risk and early intervention is the key to survival and can decrease mortality significantly. Herein, we compare the pneumonia severity index (PSI) and confusion, urea nitrogen, respiratory rate, blood pressure, age ≥ 65 (CURB-65) in terms of predicting mortality, intensive care unit (ICU) admission, and requirement of invasive mechanical ventilation. Materials and methods: The current study is a 1-year Cohort study conducted from October 2019 to September 2020. Patients hospitalized with community-acquired pneumonia (CAP) were included in the study after fulfilling the eligibility criteria. PSI and CURB-65 scores were calculated at the time of admission and compared. Follow-up of the patients was done for 30 days after admission to observe for mortality. Results: In total, 70 subjects were admitted to hospital with CAP, with male predominance. Of 70 subjects, 28 (40%) required ICU admission. The overall mortality rate was 15.7%, higher in patients above 65 years of age (33%). PSI class ≥ 4 was more accurate in predicting mortality, and admission into ICU, and PSI class 5 for the requirement of invasive ventilation than CURB-65 score ≥ 2 as calculated from the area under the curve (AUC) for the receiver operator characteristics (ROC) curve drawn for these two scores. The AUC of PSI (0.812) was higher compared to CURB-65 (0.721) in our study, making it a better predictor of mortality. PSI class ≥ 4 had higher sensitivity for predicting ICU admission but CURB-65 score ≥ 2 had higher specificity. Conclusion: The PSI is more sensitive than CURB-65 in predicting ICU admission and death, with high prognostic capacity. Therefore, it is essential for clinicians to choose the scoring index that is suitable for their local requirements.

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