Community-acquired pneumonia (CAP) remains a leading cause of death worldwide and a major burden on healthcare resources. CAP may vary in severity, from a mild disease managed in the community to a very severe illness requiring hospital or intensive care unit (ICU) admission. Illness severity is not always obvious at presentation and therefore a range of severity assessment tools have been developed to aid clinical decision making. Severity assessment toolshavebeenproventoaidthesiteofcaredecision,increasing the proportion of low-risk patients managed at home. Most severity tools were initially developed to predict mortality risk, and recent validation studies have demonstrated that risk of death is not always a good indicator for ICU care. Other severity scores have been developed recently with the aim to predict ICU admission or other clinical decisions. The introduction of biomarkers as prognostic indicators of severe CAP, whether used alone or in conjunction with other clinical severity of illness scores, is a promising area for future research. There remains no consensus on which is the best severity assessment tool in CAP. The most recent and relevant data regarding clinical prediction tools and biomarkers to predict severity in CAP are reviewed in this chapter. © 2014.
|Title of host publication||European Respiratory Monograph: Clinical Handbooks for the Respiratory Professional|
|Editors||James D. Chalmers, Mathias W. Pletz, Stefano Aliberti|
|Place of Publication||United Kingdom|
|Publisher||European Respiratory Society|
|Publication status||Published - 2014|
|Name||European Respiratory Monograph 63, March 2014|
Sintes, H., Sibila, O., Waterer, G., & Chalmers, J. D. (2014). Severity assessment tools in CAP. In J. D. Chalmers, M. W. Pletz, & S. Aliberti (Eds.), European Respiratory Monograph: Clinical Handbooks for the Respiratory Professional (Vol. 63, pp. 88-104). (European Respiratory Monograph 63, March 2014). European Respiratory Society. https://doi.org/10.1183/1025448x.10003613