Risk Prediction Models for Mortality in Community-Acquired Pneumonia: A Systematic Review

Table 1

Characteristics of derivation and validation studies which predict pneumonia mortality.

Paper	Score	Design	Setting	Year	Country	Inclusion	CAP diagnosis	Mortality outcome
BTS 1987 [22] (derivation)	British Thoracic Society Score 1, 2, 3	Prospective	Hospital	November 1982 to December 1983	UK	Adults aged 15–74 years with pneumonia	Acute illness with radiological pulmonary shadowing which was neither preexisting nor of another known cause.	Mortality
Farr et al. 1991 [23] (validation)	British Thoracic Society Score 1, 2, 3	Retrospective	Hospital	January 1984 to 1986	United States	Adults aged from 15 to 80 years with the diagnosis of pneumonia	Acute respiratory illness contracted in the community and accompanied by a new radiographic infiltrate	Mortality
Leroy et al. 1996 [14]	Mortality risk index	Combined retrospective and prospective	ICU	Derivation January 1987–December 1992. Validation January 1993–December 1994	France	Adult patients aged >16 admitted to the intensive care and infectious disease unit with the diagnosis of CAP	Admission from home or a nursing home with the presence of pulmonary infiltrate on CXR and acute onset of clinical features of pneumonia	Mortality in ICU
Neill et al. 1996 [8]	CURB	Prospective	Hospital	July 1992 to 1993	New Zealand	Adults with pneumonia without severe immunosuppression	Acute illness radiographic pulmonary shadowing with neither preexisting nor another known cause	Mortality
Fine et al. 1997 [11]	Pneumonia severity index	Prospective	Hospital (inpatients and outpatients)	1989, 1991–1993	United States and Canada	Adults aged >18 years with diagnosis of pneumonia	ICD-9-CM diagnosis of pneumonia	30-day mortality
Lim et al. 2003 [21]	CURB-65, CRB-65	Retrospective analysis of prospectively collected data	Hospital	1998–2000	UK, New Zealand, and The Netherlands	Adults with CAP	Acute respiratory tract illness associated with radiographic shadowing on an admission chest radiograph	30-day mortality
Ewig et al. 2004 [15]	Modified American Thoracic Society Rule	Prospective	Hospital	June 1998–May 2001	Spain	All patients presenting with CAP in a university hospital between June 1998 and May 2001	New pulmonary infiltrate with symptoms and signs of a lower respiratory tract infection	30-day mortality
Myint et al. 2006 [24]	SOAR	Prospective	Hospital	NA	UK	Clinical features of pneumonia and new CXR shadow	Clinical features of pneumonia and new CXR shadow	42-day mortality
Myint et al. 2007 [27] (derivation)	CURB age	Prospective	Hospital	NA	UK	Clinical features of pneumonia and new CXR shadow	Clinical features of pneumonia and new CXR shadow	42-day mortality
Escobar et al. 2008 [25]	Abbreviated Fine Score	Retrospective	Hospital	2000–2002, 2004-2005	United States	All nonobstetric, nonpsychiatric patients aged >18 years with pneumonia	ICD codes defined by Fine et al	30-day mortality
Shindo et al. 2008 [26]	A-DROP	Retrospective	Hospital	November 2005–January 2007	Japan	Patients with CAP	Pneumonia in a patient who was not hospitalized and who was carrying on with activities of daily living	30-day mortality
Myint et al. 2009 [7] (validation)	CURB age	Prospective	Hospital	2006–2008	UK	Patients with CAP	Acute illness with clinical features of lower respiratory tract infection characterized by new radiographic shadowing	30-day mortality
Myint et al. 2009 [31] (derivation)	CURSI; CURASI	Retrospective	Hospital	September 2004 to July 2005	UK	Patients with CAP	ICD-10 codes diagnosis of pneumonia	Inpatient mortality
Rello et al. 2009 [28]	PIRO score	Prospective	ICU	NA	Spain	Patients aged >18 years with pneumonia	Pneumonia confirmed by CXR and clinical findings	28-day mortality
Liapikou et al. 2009 [6]	IDSA/ATS 2007	Prospective	Hospital	January 2000–2007	Spain	Patients aged >15 years who were admitted to the emergency department for CAP in a university hospital from January 2000 through 2007	New pulmonary infiltrate on admission chest radiograph and symptoms and signs of lower respiratory tract infection	30-day mortality
Uchiyama et al. 2010 [29]	PARB	Retrospective	Hospital	March 2006 to November 2008	Japan	Adult patients with CAP	Unclear	30-day mortality or needing >2 weeks of oxygen therapy
Myint et al. 2010 [30] (validation)	CURSI, CURASI	Prospective	Hospital	2006–2008	UK	Clinical features of pneumonia and new CXR shadow	Clinical features of pneumonia and new CXR shadow	42-day mortality
Musonda et al. 2011 [32]	CARSI, CARASI	Prospective	Hospital	2008	UK	Patients with clinical and radiological features of CAP from 3 hospitals in the UK	Clinical features of pneumonia (cough, sputum, and shortness of breath, with or without fever) and new CXR shadow	30-day mortality

ICU: intensive care unit; CXR: chest X-ray; CAP: community-acquired pneumonia.