Improved prediction value of the CURB-65 score combined with the platelet-to-lymphocyte ratio for mortality in emergency department patients with severe community-acquired pneumonia.

Objective: This study aimed to evaluate the value of combining the CURB-65 score with the platelet-to-lymphocyte ratio (PLR) for predicting 30-day all-cause mortality in emergency department patients with severe community-acquired pneumonia (SCAP). Methods: This retrospective study included 214 adults with SCAP. We compared variables between survivors and nonsurvivors, performed multivariate logistic analysis to identify independent predictors, and used Kaplan-Meier analysis for survival stratification. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of CURB-65 alone and in combination with the PLR, the area under the curve (AUC) values of the two correlated ROC curves were compared with those of the DeLong test. Results: The 30-day mortality was 25.7%. The CURB-65 score was an independent predictor of mortality after multivariable adjustment (OR 2.80, 95% CI 1.87-4.18). Patients were divided into three groups on the basis of their CURB-65 score: low (0-2), medium (3), and high (4-5). The survival rate of the three groups gradually decreased, and the difference in survival curves was statistically significant ( Conclusion: Combining the CURB-65 score with the PLR improves the prediction of 30-day mortality in emergency SCAP patients, offering a reference for early risk stratification, but it is not yet a reliable predictor for individual patients.