The Effectiveness of CURB-65 and PSI Scores in Predicting Hospital Length of Stay in Patients Diagnosed with Community-Acquired Pneumonia in the Emergency Department

Abstract

Introduction: Community-acquired pneumonia (CAP) is a major cause of infectious disease mortality and a burden on healthcare systems. CURB-65 and Pneumonia Severity Index (PSI) scores assess disease severity and guide hospitalization decisions, but their role in predicting hospital stay remains unclear. This study evaluates the effectiveness of CURB-65 and PSI scores in predicting hospital stay and their utility in forecasting ICU admission and mortality. Materials and Methods: This retrospective study included adult CAP patients admitted to the Pulmonology Department via the Emergency Department between September 2021 and September 2022. CURB-65 and PSI scores were calculated, and their correlations with hospital stay, ICU admission, and mortality were analyzed using SPSS 20.0. Results: A total of 82 patients (median age 67.69 years) were included. Patients hospitalized ≤7 days had a median CURB-65 score of 1 and PSI score of 83, while those >7 days had a CURB-65 score of 2 and PSI score of 115. CURB-65 scores ≥2 were linked to prolonged stays (>7 days) in 70% of patients, compared to 41% in those ≤7 days. PSI scores also differed significantly between groups (p < 0.01). Moderate positive correlations were observed between hospital stay and both CURB-65 (r = 0.411) and PSI scores (r = 0.472). ROC analysis showed an AUC of 0.754 for PSI, with 84.8% sensitivity and 46.9% specificity. Conclusion: CURB-65 and PSI scores effectively predict hospital length of stay in CAP patients, aiding clinical decision-making and resource allocation.