Comparison of PSI, CURB-65 and I-ROAD Scoring Systems ın Patients with Community-Acquired Pneumonia

Abstract Background In patients with community-acquired pneumonia (CAP), scoring systems are important for determining disease severity and selecting the appropriate unit and antibiotics for treatment. The aim of this study was to determine the 30- and 90-day mortality rates, identify influencing factors, and compare the effectiveness of the PSI, CURB-65, and I-ROAD systems in predicting mortality among patients hospitalized for CAP. Methods We prospectively included adult patients with CAP requiring hospitalization at Hospital between January 2019 and January 2020. Patients were categorized based on the CURB-65, PSI, and I-ROAD systems, and their treatment success as well as 30- and 90-day survival rates were evaluated. Results The study comprised 60 patients with CAP, of whom 40 were male (66.7%). When assessing factors influencing 30-day mortality, the impact of immunosuppression (p:0.004), presence of malignancy (p: 0.003), Apache II score (p:0.014), and steroid use (p:0.004) was found to be significant. Both PSI and CURB-65 had a impact on 30-day mortality (p = 0.005, p = 0.007). Although there was an observed difference in mortality between the I-ROAD groups, its effect on mortality was not statistically significant (p = 0.093). Analyzing 90-day mortality revealed that the PSI and CURB-65 classifications significantly affected mortality (p < 0.001; p = 0.037). Despite a mortality difference among the mild, moderate, and severe I-ROAD groups, the difference was not statistically significant (p = 0.256). Conclusions Both PSI and CURB-65 were significant predictors for both 30-day and 90-day mortality, with PSI exhibiting the highest specificity. I-ROAD did not show statistical significance, although a notable difference was found between the groups.