The recently developed scale for assessing the severity of community-acquired pneumonia is not less than the other scales for the accuracy of predicting adverse effects of the disease in patients hospitalized for community-acquired pneumonia, and allows assign the patient to certain risk groups requiring a different level of surveillance.

The authors of a prospective study published in the June issue of Chest compared the newly developed severe community-acquired pneumonia (SCAP) score with the commonly used pneumonia severity index using an internal and external validation cohort. pneumonia severity index (PSI) and the British Thoracic Society CURB-65 scale, which includes the following categories: degree of depression of consciousness, urea level greater than 7 mmol / l, respiratory rate greater than 30 in 1 min, SBP less than 90 mm RT. Art. or DBP less than 60 mm Hg. Art., Age over 65 years. The internal cohort included 1,189 adult hospital patients; the external cohort included 671 patients hospitalized in three other hospitals. The main adverse effects were hospitalization of intensive care patients, the need for mechanical ventilation, the development of severe sepsis and treatment failure. In addition, the average length of stay in hospital has been estimated. The evaluation scales were compared taking into account their sensitivity, specificity and the area under the curve of the characteristics analyzed.

It turned out that in the two cohorts with an increase in the score on the SCAP, PSI or CURB-65 scales, there was an increase in the frequency of all adverse reactions and in the length of hospital stay (p lower 0.001). Patients assigned to the high-risk group on the SCAP scale had a higher percentage of undesirable results compared to the high-risk groups on the PSI and CURB-65 scales (hospitalization in ICU 35.8%; in mechanical ventilation 16, 4%; severe sepsis 98, 5%; therapeutic failure 22.4%). In an external cohort, the discriminatory capacity of the SCAP scale was 0.75 for patients hospitalized in ICU, 0.76 for mechanical ventilation, 0.79 for severe sepsis and 0.61 for treatment failure.

Thus, the SCAP scale is superior in terms of accuracy to the routine scales currently used to predict adverse outcomes in patients hospitalized for community-acquired pneumonia, as well as in the distribution of this category of patients by risk groups.