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

Background. Several models have been developed to predict the risk of mortality in community-acquired pneumonia (CAP). This study aims to systematically identify and evaluate the performance of published risk prediction models for CAP. Methods. We searched MEDLINE, EMBASE, and Cochrane library in No...

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Bibliographic Details
Published in:BioMed research international 2013-01, Vol.2013 (2013), p.1-12
Main Authors: Myint, Phyo Kyaw, Woo, Kenneth, Loke, Yoon K., Kwok, Chun Shing
Format: Article
Language:English
Subjects:
Accuracy
Bacterial pneumonia
Community-Acquired Infections - mortality
Community-Acquired Infections - pathology
Diagnosis
Hospitals
Humans
Illnesses
MEDLINE
Meta-analysis
Models, Statistical
Mortality
Pneumonia
Pneumonia - mortality
Pneumonia - pathology
Prognosis
Research parks
Review
Risk Assessment
Systematic review
United Kingdom
Validation studies
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Summary:Background. Several models have been developed to predict the risk of mortality in community-acquired pneumonia (CAP). This study aims to systematically identify and evaluate the performance of published risk prediction models for CAP. Methods. We searched MEDLINE, EMBASE, and Cochrane library in November 2011 for initial derivation and validation studies for models which predict pneumonia mortality. We aimed to present the comparative usefulness of their mortality prediction. Results. We identified 20 different published risk prediction models for mortality in CAP. Four models relied on clinical variables that could be assessed in community settings, with the two validated models BTS1 and CRB-65 showing fairly similar balanced accuracy levels (0.77 and 0.72, resp.), while CRB-65 had AUROC of 0.78. Nine models required laboratory tests in addition to clinical variables, and the best performance levels amongst the validated models were those of CURB and CURB-65 (balanced accuracy 0.73 and 0.71, resp.), with CURB-65 having an AUROC of 0.79. The PSI (AUROC 0.82) was the only validated model with good discriminative ability among the four that relied on clinical, laboratorial, and radiological variables. Conclusions. There is no convincing evidence that other risk prediction models improve upon the well-established CURB-65 and PSI models.
ISSN:2314-6133
2314-6141
DOI:10.1155/2013/504136