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Unveiling the prognostic potential of mayo cardiac intensive care unit admission risk score and pneumonia severity index in community-acquired pneumonia patients admitted to the intensive cardiovascular care unit
Wijaya H.S.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: Pneumonia, a prevalent comorbidity, increases mortality risk in cardiovascular disease patients. Prediction scoring systems such as M-CARS and PSI assist in treatment decisions and mortality predictions. This study compares M-CARS and PSI in predicting 30-day mortality among ICCU patients with comorbid CAP.METHODS: This 6-month prospective cohort study recruited all ICCU patients at Dr. Wahidin Sudirohusodo Hospital with comorbid CAP. Within the first 24 hours of admission, patients underwent scoring using M-CARS and PSI, which were then recorded. Patients were monitored for mortality over a 30-day follow-up period. The study subsequently compared the accuracy of M-CARS and PSI using receiver operating characteristic (ROC) curves.RESULTS: Out of the 51 patients, the majority were male (37, 72.5%), with a mean age of 58.1 ± 12.7 years. Most of our patients presented with acute coronary syndrome (74.5%). The study findings indicated that both scoring systems exhibit good accuracy based on the ROC curve analysis. M-CARS achieved an AUC of 0.717 (P=0.018), while PSI demonstrated a higher AUC of 0.915 (P<0.001). Using a cut-off of 1.5, M-CARS showed a sensitivity of 64.3% and specificity of 78.4% for predicting 30-day mortality, whereas PSI, with a cut-off of 105, demonstrated a sensitivity of 92.9% and specificity of 78%.CONCLUSIONS: The PSI and M-CARS scores exhibit similar specificity, but the PSI score demonstrates superior sensitivity compared to M-CARS. M-CARS is easier to utilize and demonstrates considerable accuracy in predicting 30-day mortality among ICCU patients with comorbid CAP.