Articles Vol. 67 No. 5 25/05/2026

ASSOCIATION AND DISCRIMINATIVE PERFORMANCE OF THE PNEUMONIA SEVERITY INDEX FOR 30-DAY MORTALITY IN OLDER ADULTS HOSPITALIZED WITH COMMUNITY-ACQUIRED PNEUMONIA

Doan Hieu Trung1,2,3,4, Nguyen Thi Thanh Van1,3, Nguyen Thi Bich Thao1,3, Tran Thi Thao Nhi1,3
1 Danang Hospital
2 Department of Internal Medicine, University of Medicine and Pharmacy
3 Bệnh viện Đà Nẵng
4 Bộ môn Nội, Trường Đại học Y Dược Đà Nẵng
DOI: 10.52163/yhc.v67i5.5124
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Keywords
Community-acquired pneumonia; older adults; Pneumonia Severity Index; 30-day mortality; prognosis; risk stratification.
Abstract

Objective:
To evaluate the association and discriminative performance of the Pneumonia Severity Index (PSI) for 30-day mortality in older adults hospitalized with community-acquired pneumonia.

 

Methods:
A prospective cohort study was conducted on 126 patients aged ≥60 years with community-acquired pneumonia admitted to the Geriatrics Department of Da Nang Hospital between March and August 2025. PSI was calculated within the first 24 hours of admission. The association between PSI and 30-day mortality was assessed using logistic regression. Discriminative performance was evaluated using the area under the receiver operating characteristic curve (AUC).

 

Results:
The mean age was 80.9 ± 10.2 years, and most patients were classified as PSI class IV–V. The 30-day mortality rate was 14.3%. Each 10-point increase in PSI was associated with a 1.16-fold increase in the odds of death (OR = 1.16; 95% CI: 0.99–1.34; p = 0.062). The overall AUC of PSI was 0.624 (95% CI: 0.474–0.770; p = 0.108), indicating limited discriminative ability. In patients aged ≥80 years, the AUC reached 0.718 (p = 0.031); however, the difference between age groups was not statistically significant.

 

Conclusions:
PSI showed a trend toward association with 30-day mortality; however, its discriminative ability was limited in this geriatric cohort. While PSI may still be useful for initial risk stratification, its prognostic value may be improved by incorporating comprehensive geriatric assessment.

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