Photo Credit: EvgeniyShkolenko

The following is a summary of “Comparative Effectiveness of qSOFA, CURB-65, and PSI in Predicting Pneumonia Hospitalization Costs in COPD Patients,” published in the October 2024 issue of Pulmonology by Jung et al.

Researchers conducted a retrospective study evaluating the effectiveness of qSOFA, CURB-65, and PSI in predicting mortality and hospitalization costs among patients with chronic obstructive pulmonary disease (COPD) under community-acquired pneumonia (CAP).

They carried out research at 7 university-affiliated medical institutes (May 2017 to February 2020) involving 349 patients who were primarily male, over 40 years old, and had a history of smoking. The CAP and COPD severity assessment was done using clinical criteria, laboratory results, and pulmonary function tests (PFT) following the 2016 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Scoring systems were evaluated using statistical analysis, including Receiver Operating Characteristic (ROC) curves and descriptive statistics, to determine predictive accuracy.

The results showed 349 patients with COPD hospitalized for CAP, with a median age of 77 years, with a predominant male ratio of 95.1%. Among the patients with COPD, 189 (54.2%) were categorized as group B and 130 patients were in group D. The predictive capabilities of the CURB-65, PSI, and qSOFA for mortality and hospitalization costs were assessed. Additionally, PSI had the highest predictive value for mortality, with an Area Under the Curve (AUC) of 0.705 (95% CI 0.654–0.752, P=0.012), followed by qSOFA, which had an AUC of 0.650 (95% CI 0.598–0.700, P=0.037). For predicting hospitalization costs that exceeded the average of 2018, PSI showed the best discriminatory power (AUC, 0.639; 95% CI 0.586–0.690, P<0.001), with CURB-65 at AUC 0.596 (95% CI 0.543–0.649, P=0.002) and qSOFA at AUC 0.591 (95% CI 0.537–0.643, P=0.003), with no significant differences observed in effectiveness among the 3 systems.

They concluded that the PSI scoring system had the highest discriminatory value in predicting both mortality and hospitalization costs among patients with pneumonia, with no significant differences in the predictive capabilities of PSI, qSOFA, Confusion, Urea nitrogen, Respiratory rate, BP, and CURB-65.

Source: journal.chestnet.org/article/S0012-3692(24)00920-6/fulltext