Prognostic values of pneumonia severity index, CURB-65 and expanded CURB-65 scores in community-acquired pneumonia in Zagazig University Hospitals

Abstract Introduction Assessment of severity and site of care decisions for community-acquired pneumonia patients (CAP) are very important for patients’ safety and optimal use of resources. Late admission to the intensive care unit (ICU) leads to increase the rate of mortality in CAP. We aimed to evaluate the effectiveness of the new expanded CURB-65 score in comparison with other pneumonia severity scoring systems (PSI, CURB-65) in predicting CAP patients’ outcomes. Methods a prospective study included 250 consecutive patients hospitalized for CAP at Chest and Tropical medicine Departments and ICUs at Zagazig University Hospitals, Egypt in the period between May 2016 and November 2016. Results The mean age of patients was 59.17 ± 14.04 years, 56% of all patients had comorbid diseases. As regards patients , outcomes (ICU admission rate, the median length of hospital stay, the overall 30-day mortality rate and need for invasive mechanical ventilation) were 29.6%, 8 days 11.2% and 23.6% respectively. COPD and liver cirrhosis were significantly associated with increased the 30-day mortality in our CAP patients. Mortality rate increased with the severity of liver cirrhosis. In the multivariate analysis (age ⩾ 65 years, LDH > 230 u/L, Albumin  Conclusions Expanded CURB-65 score is simple, objective and more accurate scoring system for evaluation of CAP severity and can improve the efficiency of predicting the mortality in CAP patients, better than CURB-65 and PSI scores. Also, Expanded CUEB-65 may generate new therapeutic and prognostic modality in CAP especially in patients with liver cirrhosis.