Vol. 6, Issue 2, Part A (2024)

Background: Community-acquired pneumonia (CAP) is a significant global health concern, with a wide range of presentations from mild respiratory symptoms to severe, life-threatening conditions such as sepsis. Due to the diversity of its clinical features, accurate assessment tools are essential for identifying high-risk patients who require intensive care. The CURB-65 score, specifically developed for CAP, predicts 30-day mortality based on clinical parameters. Meanwhile, qSOFA and NEWS2 commonly used for broader sepsis assessment, offer prognostic insights for general deterioration and ICU admission. Thus, this study aimed to compare the effectiveness of qSOFA, and NEWS2 with CURB-65 in hospitalized CAP patients. 
Materials and Methods: This prospective study involved 70 CAP patients over 18 years, admitted to the general medicine department at BMCRI-affiliated hospitals. Patients were assessed using CURB-65, NEWS2, and qSOFA, with data collected on demographic details, clinical history, blood cultures and chest X-rays, and serum urea levels. Comparative analyses were conducted to determine the sensitivity, specificity, and accuracy of each scoring system, with chi-square tests and statistical measures evaluating the association between scores and outcomes.
Results: The study's findings showed that most patients had a qSOFA score of 0 (45.7%) or 1 (38.6%), a NEWS2 score of 0 (61.4%), and a CURB-65 score of 1 (61.4%). Significant correlations were observed between qSOFA and CURB-65 scores (p = 0.001) as well as NEWS2 and CURB-65 scores (p = 0.001), with higher scores indicating a greater risk of adverse outcomes. Overall, 58.6% of patients survived, while 41.4% died, highlighting the high mortality risk associated with severe CAP.
Conclusion: The study underscores the importance of selecting the appropriate scoring system for CAP severity assessment, as qSOFA and NEWS2 scores, while useful, may provide complementary rather than stand-alone insights compared to CURB-65. These findings emphasize the need for accurate prognostic tools to optimize patient care and resource allocation in managing CAP.