Another view on the prediction of outcomes in patients with community-acquired pneumonia

To the Editors: At least two clinical rules for predicting short- and long-term mortality in patients with community-acquired pneumonia (CAP) have been successfully validated: the Pneumonia Severity Index (PSI), and the CURB-65 score (confusion, urea >7 mmol·L−1, respiratory frequency ≥30 breaths·min−1, systolic blood pressure <90 mmHg or diastolic blood pressure ≤60 mmHg and age ≥65 yrs) and its modifications. The biomarker procalcitonin (PCT) has received much attention as another tool to predict outcomes and, possibly, stratify patients according to treatment settings. Recently, we found that PCT might carry an additional predictive potential for mortality across the clinical prediction score CRB-65 (confusion, respiratory frequency ≥30 breaths·min−1, systolic blood pressure <90 mmHg or diastolic blood pressure ≤60 mmHg, and age ≥65 yrs) [1]. Schuetz et al . [2] recently reported that PCT performs poorly as a predictor of mortality and does not increase mortality prediction levels of clinical scores. There may be several reasons for …