Comparison of CURB-65 and qSOFA Combined with Serum Markers and HRCT in Predicting Mortality in AIDS with Pneumocystis jirovecii Pneumonia.

Abstract

Objective: To evaluate and compare the clinical predictive value of the CURB-65 and qSOFA scores, combined with serum markers and HRCT scores, in assessing mortality risk in Acquired Immunodeficiency Syndrome (AIDS) patients with Pneumocystis jirovecii pneumonia (PJP).

Study design: Descriptive analytical study. Place and Duration of the Study: Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China, from January to December 2022.

Methodology: Patients with AIDS and PJP were divided into two groups based on prognosis: Non-survivors (n = 35) and survivors (n = 85). Clinical data such as WBC count, CRP, PCT, CD4+ T lymphocyte count, and so on were collected. CURB-65, qSOFA, and HRCT scores were calculated. Independent risk factors for mortality were identified using logistic regression analysis, and their clinical predictive value was assessed using the area under the ROC curve (AUC).

Results: The non-survivors group had longer mechanical ventilation duration, higher rate of tracheal intubation, WBC count, CRP, PCT, CURB-65 score, qSOFA score, and HRCT score, but lower CD4+ T lymphocyte count than the survivors group (p <0.05). Univariate and multivariate logistic regression identified WBC count 1.15 × 109/L, CURB-65 score (14), qSOFA score (11.02), and HRCT score (1.37) as independent risk factors for mortality in AIDS patients with PJP (p <0.05). ROC analysis showed that CURB-65 had better predictive value than qSOFA for individual indicators (p <0.001), and CURB-65 + HRCT + WBC outperformed qSOFA+ HRCT + WBC for combined indicators (p <0.001).

Conclusion: The combination of the CURB-65 score, HRCT score, and WBC count may effectively assess disease severity and mortality risk in AIDS patients with PJP.

Key words: Acquired immunodeficiency syndrome, Pneumocystis jirovecii pneumonia, CURB-65 score and qSOFA score, Serum markers, HRCT score, Mortality prediction.