PREDICTING THE 28-DAY MORTALITY RATE IN ELDERLY PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: EVALUATION OF 11 RISK PREDICTION SCORES

Introduction: Community-acquired pneumonia frequently causes infectious disease-related morbidity and mortality among patients. Elderly patients are at a higher risk of developing severe Community-acquired pneumonia due to underlying diseases and changes in health status. We evaluated the performance of existing risk scores for predicting the 28-day mortality rate in elderly patients presenting with Community-acquired pneumonia to Emergency Department. Materials and Method: We evaluated 151 elderly patients [mean age, 76.6 +/- 7.8 years (range, 65-94 years); 65.6% men] with Community-acquired pneumonia. There were 30 deaths by day 28, with an all-cause mortality rate of 19.9%. All scores, except the CAP-PIRO, achieved an area under the receiver operating characteristic curve >0.700. Z-test was used to determine significant differences between the scores. Results: We evaluated 151 elderly patients [mean age, 76.6 +/- 7.8 years (range, 65-94 years); 65.6% men] with Community-acquired pneumonia. There were 30 deaths by day 28, with an all-cause mortality rate of 19.9%. All scores, except the CAP-PIRO, achieved an area under the receiver operating characteristic curve >0.700. Z-test was used to determine significant differences between the scores. Conclusion: Of the existing scores, 4 had good discriminatory power to predict the 28-day mortality rate. The best discrimination was demonstrated by CURB-age, a score designed for elderly patients with Community-acquired pneumonia. Additional research is necessary to determine the best risk score for predicting early mortality rates in elderly patients with Community-acquired pneumonia.