Zaki Hany A, Hamdi Alkahlout Baha, Shaban Eman, Mohamed Eslam Hussein, Basharat Kaleem, Elsayed Wael Abdelrehem Elnabawy, Azad Aftab
Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
Cardiology, Al Jufairi Diagnosis and Treatment, Doha, QAT.
Cureus. 2023 Jul 29;15(7):e42672. doi: 10.7759/cureus.42672. eCollection 2023 Jul.
The CURB-65 (confusion, uremia, respiratory rate, blood pressure, age ≥ 65 years) score and the pneumonia severity index (PSI) are widely used and recommended in predicting 30-day mortality and the need for intensive care support in community-acquired pneumonia. This study aims to compare the performance of these two severity scores in both mortality prediction and the need for intensive care support. A systematic review and meta-analysis was carried out, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 2020 guidelines, and PubMed, Scopus, ScienceDirect, and Google Scholar were searched for articles published from 2012 to 2022. The reference lists of the included studies were also searched to retrieve possible additional studies. Twenty-five studies reporting prognostic information for CURB 65 and PSI were identified. ReviewManager (RevMan) 5.4.1 was used to produce risk ratios, and a random effects model was used to pool them. Both PSI and CURB-65 showed a high strength in identifying high-risk patients. However, CURB-65 was slightly better in early mortality prediction and had more sensitivity (96.7%) and specificity (89.3%) in predicting admission to intensive care support. Thus, CURB-65 seems to be the preferred tool in predicting mortality and the need for admission into intensive care support.
CURB-65（意识模糊、尿毒症、呼吸频率、血压、年龄≥65岁）评分和肺炎严重程度指数（PSI）在预测社区获得性肺炎30天死亡率及重症监护支持需求方面被广泛应用并得到推荐。本研究旨在比较这两种严重程度评分在死亡率预测和重症监护支持需求方面的表现。按照PRISMA（系统评价和Meta分析的首选报告项目）2020指南进行了系统评价和Meta分析，并检索了PubMed、Scopus、ScienceDirect和谷歌学术中2012年至2022年发表的文章。还检索了纳入研究的参考文献列表以获取可能的其他研究。共识别出25项报告CURB-65和PSI预后信息的研究。使用ReviewManager（RevMan）5.4.1生成风险比，并采用随机效应模型进行汇总。PSI和CURB-65在识别高危患者方面均表现出较高的效能。然而，CURB-65在早期死亡率预测方面略胜一筹，在预测入住重症监护支持方面具有更高的敏感性（96.7%）和特异性（89.3%）。因此，CURB-65似乎是预测死亡率和入住重症监护支持需求的首选工具。
