ArticleThorax2006
A prospective comparison of severity scores for identifying patients with severe community acquired pneumonia: reconsidering what is meant by severe pneumonia.
Article in Thorax, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
61 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Prediction of severe community-acquired pneumonia: a systematic review and meta-analysis.Critical care (London, England) · 2012Pooled it
- Guidelines for the management of adult lower respiratory tract infections--full version.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2011Guideline
- Severity assessment tools to guide ICU admission in community-acquired pneumonia: systematic review and meta-analysis.Intensive care medicine · 2011Pooled it
- Validity of British Thoracic Society guidance (the CRB-65 rule) for predicting the severity of pneumonia in general practice: systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Pooled it
- [Consensus guidelines for the management of community acquired pneumonia in the elderly patient].Revista espanola de geriatria y gerontologiaGuideline
- Prediction of mortality in pneumonia patients with connective tissue disease treated with glucocorticoids or/and immunosuppressants by machine learning.Frontiers in immunology · 2023Trial
- How glycemic variability trajectories impact clinical outcomes in critically ill patients with severe pneumonia: a prospective cohort study.BMC anesthesiology · 2026Article
- Evaluation and Comparison of Antibiotic Prescribing Practices and Treatment Outcomes in Children with Pneumonia Admitted to Public and Private Hospitals in Pakistan: A Retrospective Study.Journal of epidemiology and global health · 2026Observational
- Fluorescence-based index from the SofiaMicrobiology spectrum · 2026Article
- Evaluation of PSI, CURB-65, and CRB-65 as prognostic tools in hospitalized immunocompetent patients with pneumonia: real-world outcomes from internal medicine wards.Pneumonia (Nathan Qld.) · 2026Article
- Predictive value of bedside lung ultrasound, quantitative chest CT, and frailty assessment for short-term outcomes in elderly patients with severe pneumonia: a pilot study.BMC pulmonary medicine · 2025Article
- Effectiveness of Yinhua Pinggan granules in community-acquired pneumonia: a randomized, double-blind clinical trial.Frontiers in pharmacology · 2025Article
- Enhancing pneumonia prognosis in the emergency department: a novel machine learning approach using complete blood count and differential leukocyte count combined with CURB-65 score.BMC medical informatics and decision making · 2024Article
- Early machine learning prediction of hospitalized patients at low risk of respiratory deterioration or mortality in community-acquired pneumonia: Derivation and validation of a multivariable model.Biomolecules & biomedicine · 2024Article
- Predictors of in-hospital mortality in elderly unvaccinated patients during SARS-CoV-2 Alpha variants epidemic.Infection prevention in practice · 2024Article
- Usefulness of a predictive model to hospitalize patients with low-risk community-acquired pneumonia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Observational
- Review
- Review
- Performance of Machine Learning Algorithms for Predicting Adverse Outcomes in Community-Acquired Pneumonia.Frontiers in bioengineering and biotechnology · 2022Article
- Significance of the Modified NUTRIC Score for Predicting Clinical Outcomes in Patients with Severe Community-Acquired Pneumonia.Nutrients · 2021Article
1 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral severity scores have been proposed to predict patient outcome and to guide initial management of patients with community acquired pneumonia (CAP). Most have been derived as predictors of mortality. A study was undertaken to compare the predictive value of these tools using different clinically meaningful outcomes as constructs for "severe pneumonia".
methodsA prospective cohort study was performed of all patients presenting to the emergency department with an admission diagnosis of CAP from March 2003 to March 2004. Clinical and laboratory features at presentation were used to calculate severity scores using the pneumonia severity index (PSI), the revised American Thoracic Society score (rATS), and the British Thoracic Society (BTS) severity scores CURB, modified BTS severity score, and CURB-65. The sensitivity, specificity, positive and negative predictive values were compared for four different outcomes (death, need for ICU admission, and combined outcomes of death and/or need for ventilatory or inotropic support).
results392 patients were included in the analysis; 37 (9.4%) died and 26 (6.6%) required ventilatory and/or inotropic support. The modified BTS severity score performed best for all four outcomes. The PSI (classes IV+V) and CURB had a very similar performance as predictive tools for each outcome. The rATS identified the need for ICU admission well but not mortality. The CURB-65 score predicted mortality well but performed less well when requirement for ICU was included in the outcome of interest. When the combined outcome was evaluated (excluding patients aged >90 years and those from nursing homes), the best predictors were the modified BTS severity score (sensitivity 94.3%) and the PSI and CURB score (sensitivity 83.3% for both).
conclusionsDifferent severity scores have different strengths and weaknesses as prediction tools. Validation should be done in the most relevant clinical setting, using more appropriate constructs of "severe pneumonia" to ensure that these potentially useful tools truly deliver what clinicians expect of them.
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