Oğuz KARCIOĞLU, Hande ÇELİK, Duygu AYDIN, Serdar CEYLAN, Aytekin İDİKUT, Ali BATUR, Elif ÖZTÜRK, Meltem Gülhan HALİL, Cafer BALCI, Mert ESME
European Journal of Geriatrics and Gerontology - 2026;8(2):83-92
Objective: Assessing the severity of community-acquired pneumonia (CAP) and selecting the appropriate care site is crucial for efficient management. Increased frailty is associated with poorer outcomes in both medical and surgical conditions. The objective of the study was to investigate how frailty affects the prognosis of CAP when assessed using frailty scales in combination with CURB-65. Materials and Methods: The severity of the CAP was assessed utilizing the CURB-65 score and the pneumonia severity index (PSI). We assessed frailty using the FRAIL (F) score and the clinical frailty scale (CFS). New scores (CURB-65-F, CURB-65-CFS) were calculated by augmenting the CURB-65 score with patients' frailty status, and a comparative analysis of patients' mortality was conducted. Results: One hundred twenty eight subjects (91 males) with a mean age of 60.10 +/- 3.98 years were included in the study. While CURB-65-F and CURB-65-CFS had comparable effects on 30-day mortality compared with CURB-65 (p = 0.001, HR = 2.245; p = 0.001, HR = 2.374; p = 0.005, HR = 2.291, respectively), they were superior at 6 months [p < 0.001, hazard ratio (HR) = 1.813; p = 0.001, HR = 1.797; p = 0.014, HR = 1.635, respectively]. Receiver operating characteristic curves evaluating the discriminatory power to predict all-cause mortality, with scores and categories analyzed independently, showed that CURB-65-CFS and CURB-65-F had greater areas under the curve [area under the curve (AUC) = 0.690, 95% confidence interval (CI): 0.590-0.789; AUC = 0.687, 95% CI: 0.586-0.787 respectively] compared with CURB-65 (AUC = 0.614, 95% CI: 0.501-0.726). Conclusion: In conclusion, using frailty scores to assess an individual's frailty may assist clinicians in more accurately estimating the mortality risk associated with CAP and in determining the site of care, with easy and rapid application at the bedside.
