RT Journal Article SR Electronic T1 Severity assessment of healthcare-associated pneumonia and pneumonia in immunosuppression JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP erj01878-2011 DO 10.1183/09031936.00187811 A1 Maria Carrabba A1 Marina Zarantonello A1 Paola Bonara A1 Cinzia Hu A1 Francesca Minonzio A1 Ivan Cortinovis A1 Silvano Milani A1 Giovanna Fabio YR 2012 UL http://erj.ersjournals.com/content/early/2012/03/08/09031936.00187811.abstract AB The study compares the ability of the PSI (pneumonia severity index), CURB (confusion-uraemia-respiratory rate-blood pressure) scales, and the SCAP (severe community-acquired pneumonia) score to predict 30-day mortality in health-care associated pneumonia (HCAP) patients, and analyses differences in the demographics, aetiology and outcomes of community-acquired pneumonia (CAP), HCAP and pneumonia in immunocompromised patients.Six hundred and twenty-nine consecutive patients admitted to a tertiary care University Hospital were prospectively categorised as having CAP (n=322) or HCAP (n=307) and the HCAP patients were further sub-divided into those who were immunocompromised (n=219) or non-immunocompromised (n=88).The 30-day mortality rate was 9.0% in the CAP group and 24.1% in the HCAP group. In the HCAP group, the PSI and SCAP scores had similar prognostic power (areas under the curve [AUC] of respectively 0.68 and 0.67 respectively), and performed better than the CURB-65 score (AUC≤0.62). Among the non-immunocompromised HCAP patients, the PSI and CURB-65 score were more sensitive than the others at every threshold, whereas SCAP was more specific than both. In the immunocompromised group, the PSI was highly sensitive but poorly specific at all thresholds.Our results suggest that prognostic tools should be designed for the subsets of HCAP patients.