Is N‐terminal pro‐B‐type natriuretic peptide ready for ‘prime time’ in severe pneumonia?

Severe pneumonia is a complex systemic process that requires a careful clinical assessment, the consideration of comorbidities and potential complications, and an understanding of the pathophysiology of inflammation. Severity assessment in pneumonia is important for risk stratification, prognosis and to determine the need for intensive care unit (ICU) admission. This information is imperative, given that delayed transfer to the ICU is associated with adverse outcomes in patients with community-acquired pneumonia1 (CAP). Several clinical scores have been validated to identify patients with CAP and healthcare-associated pneumonia requiring ICU admission, and among them, the 2007 Infectious Diseases Society of America/American Thoracic Society minor criteria appear to be a suitable predictor of ICU admission and 30-day mortality.2,3 However, none of these clinical scores have been substantially successful in assessing the severity and predicting the need for ICU admission in severe pneumonia.