Leidi Tommaso, Gerstel Eric, Garin Nicolas
Service de médecine interne générale, Département de médecine interne, HUG, 1211 Genève 14.
Rev Med Suisse. 2009 Oct 14;5(221):2040-2, 2044.
Patients presenting with severe community-acquired pneumonia (CAP) should be accurately identified, since they need admission to acute care units. Prognostic scores routinely used for CAP (PSI and CURB-65) predict 30-day mortality, and are helpful for hospitalization decisions. However, 30-day death risk is largely determined by age and comorbidities, and does not correlate well with the severity of CAP. PSI and CURB-65 are therefore not efficient for identifying patients who require intensive monitoring. Specifically developed scores are either not accurate enough or insufficiently validated to help determine the best site of care for hospitalized patients with CAP.