ArticleInfection and drug resistance2024
CAP-PIRO Scoring System's Performance in Predicting Prognosis and Severity of Community-Acquired Pneumonia: A Single-Center Prospective Study.
Article in Infection and drug resistance, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Community-acquired pneumonia (CAP) is a significant global health issue, leading to high morbidity and mortality rates. Despite the existence of various severity scoring systems, accurately predicting patient outcomes remains challenging. The CAP-PIRO (Predisposition, Insult, Response, and Organ dysfunction) scoring system offers a comprehensive approach to evaluating CAP severity and prognosis. Objective: This study aimed to assess the effectiveness of the CAP-PIRO scoring system in predicting the prognosis and severity of CAP patients, focusing on the development of acute respiratory distress syndrome (ARDS) and 28-day mortality. Methods: A total of 875 CAP patients were prospectively enrolled from the emergency department of Beijing Chao-yang Hospital between November 2017 and December 2023. Clinical data, including patient demographics, medical history, vital signs, and laboratory findings, were collected within 6 hours of admission. CAP-PIRO, CURB-65, and PSI scores were calculated. Patients were stratified based on ARDS development, 28-day mortality, and PaO2/FiO2 categories (≤100 mmHg, 100-200 mmHg, 200-300 mmHg). Results: Significant differences were observed in PCT, blood lactate (Lac), CURB-65, PSI, and CAP-PIRO scores between patients with and without ARDS, as well as between survivors and non-survivors at 28 days (P<0.05). CAP-PIRO and Lac were identified as independent predictors for ARDS development and 28-day mortality. The area under the ROC curve (AUC) for CAP-PIRO was higher than that for CURB-65 and PSI in predicting 28-day mortality. The combination of CAP-PIRO and Lac demonstrated improved predictive accuracy for ARDS. Notably, significant differences in CAP-PIRO scores were observed across different PaO2/FiO2 groups. Conclusion: CAP-PIRO demonstrates strong predictive ability for adverse outcomes and, when combined with lactate, shows enhanced predictive power. These findings underscore the value of CAP-PIRO for clinical risk stratification in CAP patients.
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