Objective To study the value of there different scoring systems,such as the quick Sepsis-related Organ Failure Assessment (qSOFA), the 6-point CURB-65 scale adopted by the British Thoracic Society and the simpler CRB-65 for assessing 28-day mortality in severe community-acquired pneumonia(SCAP) patients. Methods The 164 patients with SCAP from January 2015 to March 2017 were collected and analyzed,the qSOFA,CURB-65 and CRB-65 scores were calculated respectively. The difference of 28-day mortality in each risk score of the differ-ent scoring systems were analyzed. According to prognosis of 28 days, we drew the receiver-operating characteristic (ROC) curves of the three scoring systems and compared their area under the curve(AUC) to determine the predic-tive value of severity. Results 164 patients were enrolled in this study and the overall mortality were 36.6%. The qSOFA,CURB-65 and CRB-65 scores of the survival group were lower than those of the death group(P<0.05). All the three predictive rules showed the same trend of increasing mortality with the higher scores (P<0.05). For pre-dicting 28-day mortality,the qSOFA,CURB-65 and CRB-65 performed similarly, and the areas under the receiver operating characteristic (ROC) curve were 0.735 (95% CI 0.627 to 0.843),0.763 (95% CI 0.662 to 0.865) and 0.737 (95% CI 0.626 to 0.848),respectively. Conclusion The new scoring system qSOFA also can predict the severity of patients with severe community-acquired pneumonia.The qSOFA score, CURB-65 score and CRB-65 score have a similar performance in predicting the severity of SCAP patients.%目的 探讨快速序贯器官衰竭评分(qSOFA)、英国胸科协会改良肺炎评分(CURB-65)和简化CURB-65评分(CRB-65)三种评分系统预测重症社区获得性肺炎(severe community acquired pneumonia, SCAP)患者死亡的价值.方法 收集2015年1月至2017年3月入住安徽医科大学第二附属医院呼吸内科的SCAP患者共164例,分析其一般临床资料,统计每例的qSOFA、CURB-65与CRB-65评分,比较各评分系统不同分值的患者间死亡率的差异,患者28天预后作为临床观察终点,以受试者工作特征曲线(ROC)来分析三种评分系统对SCAP 严重程度的预测效能.结果 最终纳入164例患者,28天死亡60例,死亡率为36.6%.三种评分系统中死亡组评分均明显高于存活组(P<0.05),且各评分系统中随着评分数值的升高SCAP死亡率均呈上升趋势(P<0.05).ROC 曲线分析显示,qSOFA、CURB-65、CRB-65评分三种评分系统均能预测SCAP患者28天的死亡风险,曲线下面积(AUC)分别是0.74 (95% CI 0.63-0.84)、0.76 (95% CI 0.66-0.87)、0.74(95% CI 0.63 -0.85),三者之间无统计学差异.结论 新评分系统qSOFA也可预测重症社区获得性肺炎患者的严重程度,其预测效能与CURB-65、CRB-65评分相当,值得推广.
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