Background: Community-acquired pneumonia (CAP) is a major health concern and the leading cause of death among infectious diseases, with significant implications for healthcare systems worldwide. Poor outcomes are typically attributed to the severity of the infection, as well as patient characteristics and co-morbidities. CURB-65 is used to assess the severity of CAP. The aim of this study is to compare the in-hospital mortality rates by different CURB type severity scores.

Methods :We used the Quality Assessment(QA) Research Database for Pneumonia in Korea. The QA database included the data reported from the three rounds of QA. The patients who met the criteria of hospitalized CAP were enrolled.

Results: Total 54,307 patients from QA database were screened, and 44,099 of them were included in the study. The average age of the patients was 64.6 years, and 47.5% were male. The hospital length of stay was an average of 8.9±6.1 days, and patients were treated with antibiotics for an average of 8.3±5.3 days. Overall, the in-hospital mortality rate was 3.0% (1,308 patients). Table 1 shows the distribution of patients across different severity scores for four different pneumonia severity assessment tools: CURB-65, CRB-65, CURB, and CRB. The results show that patients with higher severity scores had a higher risk of mortality, as expected. Among the four assessment tools, CURB-65 has the highest AUROC value (0.829), followed by CURB (0.797).

Conclusion: In the three severity scores created by simplifying the curb-65 items, when the score increased, the mortality rate also increased. However, CURB-65 has the highest predictive accuracy for in-hospital mortality among the severity assessment tools.