Kamil KOKULU, Ekrem Taha SERT
The Medical Bulletin of Haseki - 2026;64(2):101-107
Aim: Accurate early risk stratification is essential for guiding disposition and monitoring decisions in community-acquired pneumonia (CAP) in the emergency department. We aimed to evaluate the prognostic performance of the PATHOS score and compare it with CURB-65 and A-DROP in predicting 30-day mortality in adult patients with CAP. Methods: This retrospective, single-center observational cohort study included consecutive adult patients (>=18 years) presenting to the emergency department with CAP between January 1, 2019, and January 1, 2024. Patient data were obtained from the hospital's electronic medical record system using the International Classification of Diseases, Tenth Revision. CURB-65, A-DROP, and PATHOS scores were calculated based on the collected data. The ability of the PATHOS score to predict 30-day mortality was evaluated and compared with CURB-65 and A-DROP scores. Results: A total of 605 cases were included in the study. The overall 30-day mortality rate was 8.6%. In predicting 30-day mortality, the PATHOS score [area under the curve (AUC)=0.849] demonstrated better performance than CURB-65 (AUC=0.733) and A-DROP (AUC=0.780). A PATHOS score of >3 was identified as the optimal threshold for predicting 30-day mortality, with a sensitivity of 75.0%, a specificity of 86.8%, and a negative predictive value of 97.4%. Conclusion: Our findings indicate that the PATHOS score can serve as an effective tool in the clinical management of patients with CAP and contribute significantly to clinical decision-making.
