Objective To evaluate the value of quick Sequential Organ Failure Assessment (qSOFA) score and CURB65 score for assessing the severity and prognoses of community-acquired pneumonia (CAP). Methods A retro-spective analysis of clinical data of adult patients who fulfilled the CAP criteria admitted to the Department of Emergen-cy of the Second Affiliated Hospital of Hainan Medical University from January 2012 to June 2016 was conducted.The qSOFA score and CURB-65 score were calculated at enrollment. The qSOFA score and CURB-65 scores were com-pared between patients with severe CAP (SCAP) and non-SCAP (NSCAP), survivors and non-survivors. Receiver oper-ating characteristic (ROC) curve was drawn, and areas under the curves (AUC) were compared to evaluate the value of the qSOFA score and CURB-65 score in the prediction of patients' severity and prognoses. Results A total of 320 CAP patients, including 80 of SCAP, were enrolled;the 28-day mortality of the study was 21.3%(68/320). The qSO-FA score and CURB-65 score in SCAP patients were (2.08 ± 0.86) and (3.98 ± 1.00), respectively, which were signifi-cantly higher than corresponding (0.69 ± 0.73) and (2.18 ± 1.32) in NSCAP patients (P=0.000); the qSOFA score and CURB-65 score in non-survivors were (2.18±0.87) and (4.12±0.98), which were significantly higher than correspond-ing (0.73 ± 0.74) and (2.23 ± 1.32) in survivors (P=0.000). The area under ROC curve of the qSOFA score and CURB-65 score were 0.874 and 0.878 in predictors of SCAP, and no difference was found between them (Z=0.175, P=0.861).The area under ROC curve of the qSOFA score and CURB-65 score were 0.831 and 0.870 in predicting the risk of 28-day mortality, and no difference was found between them (Z=0.713, P=0.476). Conclusion Both the qSO-FA score and the CURB-65 score are valuable for evaluating the severity and prognoses of CAP patients in emergen-cy department. And the qSOFA score has advantages of more simple and easier over the CURB-65, which is worthy of clinical application.%目的 探讨快速序贯器官衰竭评估(qSOFA)评分与CURB-65评分对急诊社区获得性肺炎(CAP)严重程度和预后判断的评估价值.方法 采用回顾性研究方法,选择2012年1月至2016年6月海南医学院第二附属医院急诊科收治的符合CAP诊断标准的成年患者,均进行qSOFA评分和CURB-65评分,比较入选时重症社区获得性肺炎(SCAP)患者与非重症社区获得性肺炎(NSCAP)患者、28 d死亡与存活患者之间各指标的差异;并通过绘制各评分的受试者工作特征曲线(ROC),比较各曲线下面积(AUC),评估qSOFA评分和CURB-65评分对CAP严重性和预后的预测价值.结果 共入选CAP患者320例,其中SCAP患者80例;28 d病死率为21.3%(68/320).SCAP患者qSOFA评分[(2.08±0.86)分vs(0.69±0.73)分,P=0.000]和CURB-65评分[(3.98±1.00)分vs(2.18±1.32)分,P=0.000]显著高于NSCAP患者;28 d死亡患者qSOFA评分[(2.18±0.87)分vs(0.73±0.74)分,P=0.000]和CURB-65评分CURB-65评分[(4.12±0.98)分vs(2.23±1.32)分,P=0.000]显著高于存活患者.qSOFA评分和CURB-65评分预测SCAP的AUC分别为0.874和0.878,两者比较差异无统计学意义(Z=0.175,P=0.861);预测患者预后的AUC分别为0.831和0.870,两者比较差异无统计学意义(Z=0.713,P=0.476).结论 qSOFA评分与CURB-65评分一样,均能有效评估急诊CAP的严重程度并判断预后,并且qSOFA评分较CURB-65评分具有更简洁易行的优势,值得临床加于应用.
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