APACHE II versus CURB-65 as a Prognostic Score to Assess Severity of Pneumonia Causing Sepsis in Critically Ill Patients

Abstract

Abstract Background The Pneumonia Severity Index (PSI) and CURB-65 score are commonly used to stratify patients based on mortality risk in both clinical and research settings. However, their comparative predictive accuracy remains a subject of debate. Aim of the Work The aim of this study is to compare the efficacy between CURB-65 and APACHE II in assessment of the severity of pneumonia causing sepsis and predicting mortality in critically ill patients. Methods This study aimed to compare the efficacy of CURB-65 and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores in assessing pneumonia-induced sepsis severity and predicting mortality in critically ill patients. Two groups were formed, with Group A assessed using CURB-65 and Group B assessed using APACHE II scores. The study was conducted at the Critical Care department of Ain Shams University Hospitals, Cairo, Egypt. Results Our findings were in agreement with previous studies on various parameters such as mean arterial pressure, respiratory rate, and temperature. However, significant differences were observed in pulse and Glasgow Coma Scale (GCS). In contrast to other reports, our study did not find any significant difference in total leukocyte count between the two groups. Conclusion The CURB-65 score showed statistically significant differences in certain parameters between the survivor and non-survivor groups. The APACHE II score performed better than CURB-65 as an initial prognostic assessment in patients with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Moreover, the area under the ROC curve for APACHE II was greater than that for CURB-65, indicating better predictive accuracy for 28-day mortality. The choice between these scoring systems should be carefully considered when assessing the severity and predicting mortality in critically ill patients with pneumonia-induced sepsis. Further studies are warranted to validate these findings and optimize patient outcomes.