Comparison of pneumonia severity scores for patients diagnosed with pneumonia in emergency department

BACKGROUND & OBJECTIVES: Sepsis due to pneumonia or pneumonia itself is one of the main causes of deaths in patients despite the advanced treatment methods. The optimal prognostic tool in pneumonia is still not clear. This study was aimed to compare the pneumonia severity scores and the possibility of using the new scores in patients who were diagnosed with pneumonia in the emergency department. METHODS: Demographic data, laboratory and imaging results, confusion, elevated blood urea nitrogen, respiratory rate and blood pressure plus age ≥65 yr (CURB-65), pneumonia severity index (PSI), national early warning score (NEWS), NEWS-lactate (NEWS-L) scores, hospitalization, referral, discharge and 30-day mortality of patients who were diagnosed with pneumonia in emergency department were recorded. RESULTS: A total of 250 patients were included in the study. The most successful score in predicted mortality was found to be NEWS-L. This was followed by NEWS, CURB-65 and PSI, respectively. Most successful scores in anticipation of admission to the intensive care unit were NEWS-L followed by NEWS. This was followed by CURB-65 and PSI scores, respectively. The most successful score in anticipation of hospital admission was NEWS-L, followed by NEWS, CURB-65 and PSI, respectively. There was a significant difference between all pneumonia severity scores of the patients who died and survived within 30 days. There was a significant difference between the scores of patients in intensive care unit (ICU) and service, compared to non-ICU patients. INTERPRETATION & CONCLUSIONS: NEWS-L score was found to be the most successful score in predicting mortality, ICU admission and hospitalization requirement. Both NEWS-L and NEWS scores can be used in determining the mortality, need for hospitalization and intensive care of the patients with pneumonia in the emergency department.