Which Prognostic Tools Best Predict Mortality in Patients with Community-Acquired Pneumonia?

Several validated clinical decision rules — CURB-65 (Confusion, Urea, Respiratory Rate, Blood Pressure, Age ≥65), CRB (Confusion, Respiratory Rate, Blood Pressure), and PSI (Pneumonia Severity Index) — help classify risk in patients with community-acquired pneumonia (CAP). Recently, the Sepsis-3 Task Force presented new prognostic tools, Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) to replace the systemic inflammatory response syndrome (SIRS) criteria in identifying patients with sepsis (NEJM JW Gen Med Mar 15 2016 and JAMA 2016; 315:775; Table).

In a retrospective study in >6500 CAP patients in two Spanish cohorts, investigators evaluated each tool's ability to classify mortality risk or need for critical care support. …